Pyrazole-amide compounds and pharmaceutical use thereof

ABSTRACT

A compound represented by the following formula: 
     
       
         
         
             
             
         
       
     
     wherein n is 1 or 2, 
     
       
         
         
             
             
         
       
     
     or a pharmaceutically acceptable salt thereof,
 
and a pharmaceutical use thereof.

TECHNICAL FIELD

The present invention provides a pyrazole-amide compound and apharmaceutical use thereof. More particularly, the present inventionrelates to a pyrazole-amide compound or a pharmaceutically acceptablesalt thereof having a pyruvate dehydrogenase kinase (hereinafter to beabbreviated as PDHK) inhibitory activity, a pharmaceutical compositioncontaining the same, a prophylactic or therapeutic agent containing thesame for diabetes (type 1 diabetes, type 2 diabetes etc.), insulinresistance syndrome, metabolic syndrome, hyperglycemia,hyperlactacidemia, diabetic complications (diabetic neuropathy, diabeticretinopathy, diabetic nephropathy, cataract etc.), cardiac failure(acute cardiac failure, chronic cardiac failure), cardiomyopathy,myocardial ischemia, myocardial infarction, angina pectoris,dyslipidemia, atherosclerosis, peripheral arterial disease, intermittentclaudication, chronic obstructive pulmonary disease, brain ischemia,cerebral apoplexy, mitochondrial disease, mitochondrialencephalomyopathy, cancer, pulmonary hypertension, or Alzheimer disease,and the like.

BACKGROUND ART

In tissues, for reactions using energy such as biosynthesis, activetransport, muscle contraction and the like, the energy is supplied byhydrolysis of adenosine triphosphate (ATP). ATP is produced by oxidationof metabolic fuel which yields much energy, such as glucose and freefatty acids. In oxidative tissues such as muscle, ATP is mostly producedfrom acetyl-CoA that enters citric acid cycle. Acetyl-CoA is produced byoxidation of glucose via glycolytic pathway or R oxidation of free fattyacid. An enzyme that plays a pivotal role in controlling acetyl-CoAproduction from glucose is pyruvate dehydrogenase (hereinafter to beabbreviated as PDH). PDH catalyzes reduction of nicotinamide adeninedinucleotide (NAD) to NADH, simultaneously with oxidation of pyruvicacid to acetyl-CoA and carbon dioxide (e.g., non-patent documents 1, 2).

PDH is a multienzyme complex consisting of three enzyme components (E1,E2 and E3) and some subunits localized in mitochondrial matrix. E1, E2and E3 are responsible for decarboxylation from pyruvic acid, productionof acetyl-CoA and reduction of NAD to NADH, respectively.

Two classes of enzyme having regulatory function bind to PDH. One isPDHK, which is a protein kinase having specificity to PDH. The rolethereof is to inactivate E1α subunit of the complex by phosphorylation.The other is PDH phosphatase, which is a specific protein phosphatasethat activates PDH via dephosphorylation of E1α subunit. The proportionof PDH in its active (dephosphorylated) state is determined by thebalance of kinase activity and phosphatase activity. The kinase activityis regulated by the relative concentration of metabolic substrates. Forexample, the kinase activity is activated by an increase in NADH/NAD,acetyl-CoA/CoA and ATP/adenosine diphosphate (ADP) ratios, and inhibitedby pyruvic acid (e.g., non-patent document 3).

In the tissues of mammals, 4 kinds of PDHK isozymes are identified.Particularly, PDHK2 is expressed in a wide range of tissues includingthe liver, skeletal muscles and adipose tissues involved in glucosemetabolism. Furthermore, since PDHK2 shows comparatively highsensitivity to activation by increased NADH/NAD or acetyl-CoA/CoA andinhibition by pyruvic acid, involvement in a short-term regulation ofglucose metabolism is suggested (e.g., non-patent document 4).

In addition, PDHK1 is expressed in large amounts in cardiac muscle,skeletal muscle, pancreatic β cell and the like. Furthermore, sinceexpression of PDHK1 is induced via activation of hypoxia induciblefactor (HIF) 1 in ischemic state, its involvement in ischemic diseasesand cancerous diseases is suggested (e.g., non-patent document 5).

In diseases such as insulin-dependent (type 1) diabetes,non-insulin-dependent (type 2) diabetes and the like, oxidation oflipids is promoted with simultaneous reduction in glucose utilization.This reduction in glucose utilization is one of the factors causinghyperglycemia. When the oxidative glucose metabolism decreases in type 1and type 2 diabetes and obesity, PDH activity also decreases. Itsuggests involvement of reduced PDH activity in the reduced glucoseutilization in type 1 and type 2 diabetes (e.g., non-patent documents 6,7).

On the contrary, hepatic gluconeogenesis is enhanced in type 1 and type2 diabetes, which also forms one factor causing hyperglycemia. Thereduced PDH activity increases pyruvic acid concentration, which in turnincreases availability of lactic acid as a substrate for hepaticgluconeogenesis. It suggests possible involvement of reduced PDHactivity in the enhanced gluconeogenesis in type 1 and type 2 diabetes(e.g., non-patent documents 8, 9). When PDH is activated by inhibitionof PDHK, the rate of glucose oxidation is considered to rise. As aresult, glucose utilization in the body is promoted and hepaticgluconeogenesis is suppressed, whereby hyperglycemia in type 1 and type2 diabetes is expected to be improved (e.g., non-patent documents 10,11, 12). Another factor contributing to diabetes is impaired insulinsecretion, which is known to be associated with reduced PDH activity inpancreatic β cells, and introduction of PDHK1, 2 and 4 (e.g., non-patentdocuments 13, 14). In addition, sustained hyperglycemia due to diabetesis known to cause complications such as diabetic neuropathy, diabeticretinopathy, diabetic nephropathy and the like. Thiamine and α-lipoicacid contribute to activation of PDH as coenzymes. Thiamine and α-lipoicacid, or thiamine derivative and α-lipoic acid derivative are shown tohave a promising effect on the treatment of diabetic complications.Thus, activation of PDH is expected to improve diabetic complications(e.g., non-patent documents 15, 16).

Under ischemic conditions, limited oxygen supply reduces oxidation ofboth glucose and fatty acid and reduces the amount of ATP produced byoxidative phosphorylation in the tissues. In the absence of sufficientoxygen, ATP level is maintained by promoted anaerobic glycolysis. As aresult, lactic acid increases and intracellular pH decreases. Eventhough the body tries to maintain homeostasis of ion by energyconsumption, abnormally low ATP level and disrupted cellular osmolaritylead to cell death. In addition, adenosine monophosphate-activatingkinase, activated during ischemia, phosphorylates and thus inactivatesacetyl-CoA carboxylase. The levels of total malonyl-CoA in the tissuedrop, carnitine palmitoyltransferase-I activity is therefore increasedand fatty acid oxidation is favored over glucose oxidation by allowingthe transport of acyl-CoA into mitochondria. Oxidation of glucose iscapable of yielding more ATP per molecule of oxygen than is oxidation offatty acids. Under ischemic conditions, therefore, when energymetabolism becomes glucose oxidation dominant by activation of PDH, theability to maintain ATP level is considered to be enhanced (e.g.,non-patent document 17).

In addition, since activation of PDH causes oxidation of pyruvic acidproduced by glycolysis, and reducing production of lactic acid, the netproton burden is considered to be reduced in ischemic tissues.Accordingly, PDH activation by inhibition of PDHK is expected toprotectively act in ischemic diseases such as cardiac muscle ischemia(e.g., non-patent documents 18, 19).

A drug that activates PDH by inhibition of PDHK is considered todecrease lactate production since it promotes pyruvate metabolism.Hence, such drug is expected to be useful for the treatment ofhyperlactacidemia such as mitochondrial disease, mitochondrialencephalomyopathy and sepsis (e.g., non-patent document 20).

In cancer cells, the expression of PDHK1 or 2 increases. In cancercells, moreover, ATP production by oxidative phosphorylation inmitochondria decreases, and ATP production via the anaerobic glycolysisin cytoplasm increases. PDH activation by inhibition of PDHK is expectedto promote oxidative phosphorylation in mitochondria, and increaseproduction of active oxygen, which will induce apoptosis of cancercells. Therefore, the PDH activation by PDHK inhibition is useful forthe treatment of cancerous diseases (e.g., non-patent document 21).

Pulmonary hypertension is characterized by high blood pressure caused bypartial narrowing of the pulmonary artery due to promoted cellproliferation therein. In pulmonary hypertension, therefore, activationof PDH in the pulmonary artery cell is expected to promote oxidativephosphorylation in mitochondria, increase production of active oxygen,and induce apoptosis of the pulmonary artery cells. Therefore, the PDHactivation by PDHK inhibition is considered to be useful for thetreatment of pulmonary hypertension (e.g., non-patent document 22).

Energy production and glucose metabolism in the cerebrum decrease inAlzheimer disease, and also, PDH activity declines. When the PDHactivity declines, production of acetyl CoA decreases. Acetyl CoA isutilized for ATP production in the electron transport system via thecitric acid cycle. Acetyl CoA is also a starting material forsynthesizing acetylcholine, which is one of the neurotransmitters.Therefore, reduced brain PDH activity in Alzheimer disease is consideredto cause neuronal cell death due to the decreased ATP production.Moreover, it is considered that synthesis of acetylcholine, which is thetransmitter for cholinergic nerve, is inhibited to induce deteriorationof memory and the like. Activation of PDH in the brain is expected toenhance energy production and acetylcholine synthesis in Alzheimerdisease. Therefore, activation of PDH by the inhibition of PDHK isconsidered to be useful for the treatment of Alzheimer disease (e.g.,non-patent documents 23, 24).

It has been shown that dichloroacetic acid, which is a drug having a PDHactivating action, provides promising effects for the treatment ofdiabetes, myocardial ischemia, myocardial infarction, angina pectoris,cardiac failure, hyperlactacidemia, brain ischemia, cerebral apoplexy,peripheral arterial disease, chronic obstructive pulmonary disease,cancerous disease, and pulmonary hypertension (e.g., non-patentdocuments 10, 18, 20, 22, 25, 26, 27).

From the foregoing findings, a PDHK inhibitor is considered to be usefulfor the prophylaxis or treatment of diseases relating to glucoseutilization disorder, for example, diabetes (type 1 diabetes, type 2diabetes etc.), insulin resistance syndrome, metabolic syndrome,hyperglycemia, hyperlactacidemia, diabetic complications (diabeticneuropathy, diabetic retinopathy, diabetic nephropathy, cataract etc.).Furthermore, a PDHK inhibitor is considered to be useful for theprophylaxis or treatment of diseases caused by limited energy substratesupply to the tissues, for example, cardiac failure (acute cardiacfailure, chronic cardiac failure), cardiomyopathy, myocardial ischemia,myocardial infarction, angina pectoris, dyslipidemia, atherosclerosis,peripheral arterial disease, intermittent claudication, chronicobstructive pulmonary disease, brain ischemia and cerebral apoplexy.

Therefore, a PDHK inhibitor is considered to be useful for the treatmentor prophylaxis of diabetes (type 1 diabetes, type 2 diabetes etc.),insulin resistance syndrome, metabolic syndrome, hyperglycemia,hyperlactacidemia, diabetic complications (diabetic neuropathy, diabeticretinopathy, diabetic nephropathy, cataract etc.), cardiac failure(acute cardiac failure, chronic cardiac failure), cardiomyopathy,myocardial ischemia, myocardial infarction, angina pectoris,dyslipidemia, atherosclerosis, peripheral arterial disease, intermittentclaudication, chronic obstructive pulmonary disease, brain ischemia,cerebral apoplexy, mitochondrial disease, mitochondrialencephalomyopathy, cancer, pulmonary hypertension or Alzheimer disease.

DOCUMENT LIST Non-Patent Documents

-   non-patent document 1: Reed L J, Hackert M L. Structure-function    relationships in dihydrolipoamide acyltransferases. J Biol Chem.    1990 Jun. 5; 265(16):8971-4.-   non-patent document 2: Patel M S, Roche T E. Molecular biology and    biochemistry of pyruvate dehydrogenase complexes. FASEB J. 1990    November; 4(14):3224-33.-   non-patent document 3: Sugden M C, Holness M J. Recent advances in    mechanisms regulating glucose oxidation at the level of the pyruvate    dehydrogenase complex by PDKs. Am J Physiol Endocrinol Metab. 2003    May; 284(5):E855-62.-   non-patent document 4: Bowker-Kinley M M, Davis W I, Wu P, Harris R    A, Popov K M. Evidence for existence of tissue-specific regulation    of the mammalian pyruvate dehydrogenase complex. Biochem J. 1998    Jan. 1; 329 (Pt 1):191-6.-   non-patent document 5: Kim J W, Tchernyshyov I, Semenza G L, Dang    C V. HIF-1-mediated expression of pyruvate dehydrogenase kinase: a    metabolic switch required for cellular adaptation to hypoxia. Cell    Metab. 2006 March; 3(3):177-85.-   non-patent document 6: Morino K, Petersen K F, Dufour S, Befroy D,    Frattini J, Shatzkes N, et al. Reduced mitochondrial density and    increased IRS-1 serine phosphorylation in muscle of    insulin-resistant offspring of type 2 diabetic parents. J Clin    Invest. 2005 December; 115(12):3587-93.-   non-patent document 7: Caterson I D, Fuller S J, Randle P J. Effect    of the fatty acid oxidation inhibitor 2-tetradecylglycidic acid on    pyruvate dehydrogenase complex activity in starved and    alloxan-diabetic rats. Biochem J. 1982 Oct. 15; 208(1):53-60.-   non-patent document 8: Boden G, Chen X, Stein T P. Gluconeogenesis    in moderately and severely hyperglycemic patients with type 2    diabetes mellitus. Am J Physiol Endocrinol Metab. 2001 January;    280(1):E23-30.-   non-patent document 9: Shangraw R E, Fisher D M. Pharmacokinetics    and pharmacodynamics of dichloroacetate in patients with cirrhosis.    Clin Pharmacol Ther. 1999 October; 66(4):380-90.-   non-patent document 10: Stacpoole P W, Moore G W, Kornhauser D M.    Metabolic effects of dichloroacetate in patients with diabetes    mellitus and hyperlipoproteinemia. N Engl J Med. 1978 Mar. 9;    298(10):526-30.-   non-patent document 11: Mayers R M, Leighton B, Kilgour E. PDH    kinase inhibitors: a novel therapy for Type II diabetes?Biochem Soc    Trans. 2005 April; 33(Pt 2):367-70.-   non-patent document 12: Jeoung N H, Rahimi Y, Wu P, Lee W N, Harris    R A. Fasting induces ketoacidosis and hypothermia in    PDHK2/PDHK4-double-knockout mice. Biochem J. 2012 May 1;    443(3):829-39.-   non-patent document 13: Zhou Y P, Berggren P O, Grill V. A fatty    acid-induced decrease in pyruvate dehydrogenase activity is an    important determinant of beta-cell dysfunction in the obese diabetic    db/db mouse. Diabetes. 1996 May; 45(5):580-6.-   non-patent document 14: Xu J, Han J, Epstein P N, Liu Y Q.    Regulation of PDK mRNA by high fatty acid and glucose in pancreatic    islets. Biochem Biophys Res Commun. 2006 Jun. 9; 344(3):827-33.-   non-patent document 15: Benfotiamine. Monograph. Altern Med Rev.    2006 September; 11(3):238-42.-   non-patent document 16: Vallianou N, Evangelopoulos A, Koutalas P.    Alpha-lipoic Acid and diabetic neuropathy. Rev Diabet Stud. 2009    Winter; 6(4):230-6.-   non-patent document 17: Ussher J R, Lopaschuk G D. The malonyl CoA    axis as a potential target for treating ischaemic heart disease.    Cardiovasc Res. 2008 Jul. 15; 79(2):259-68.-   non-patent document 18: Wargovich T J, MacDonald R G, Hill J A,    Feldman R L, Stacpoole P W, Pepine C J. Myocardial metabolic and    hemodynamic effects of dichloroacetate in coronary artery disease.    Am J Cardiol. 1988 Jan. 1; 61(1):65-70.-   non-patent document 19: Taniguchi M, Wilson C, Hunter C A, Pehowich    D J, Clanachan A S, Lopaschuk G D. Dichloroacetate improves cardiac    efficiency after ischemia independent of changes in mitochondrial    proton leak. Am J Physiol Heart Circ Physiol. 2001 April;    280(4):H1762-9.-   non-patent document 20: Stacpoole P W, Nagaraja N V, Hutson A D.    Efficacy of dichloroacetate as a lactate-lowering drug. J Clin    Pharmacol. 2003 July; 43(7):683-91.-   non-patent document 21: Bonnet S, Archer S L, Allalunis-Turner J,    Haromy A, Beaulieu C, Thompson R, et al. A mitochondria-K+channel    axis is suppressed in cancer and its normalization promotes    apoptosis and inhibits cancer growth. Cancer Cell. 2007 January;    11(1):37-51.-   non-patent document 22: McMurtry M S, Bonnet S, Wu X, Dyck J R,    Haromy A, Hashimoto K, et al. Dichloroacetate prevents and reverses    pulmonary hypertension by inducing pulmonary artery smooth muscle    cell apoptosis. Circ Res. 2004 Oct. 15; 95(8):830-40.-   non-patent document 23: Saxena U. Bioenergetics breakdown in    Alzheimer's disease: targets for new therapies. Int J Physiol    Pathophysiol Pharmacol. 2011; 3(2):133-9.-   non-patent document 24: Stacpoole P W. The pyruvate dehydrogenase    complex as a therapeutic target for age-related diseases. Aging    Cell. 2012 June; 11(3):371-7.-   non-patent document 25: Marangos P J, Turkel C C, Dziewanowska Z E,    Fox A W. Dichloroacetate and cerebral ischaemia therapeutics. Expert    Opin Investig Drugs. 1999 April; 8(4):373-82.-   non-patent document 26: Calvert L D, Shelley R, Singh S J, Greenhaff    P L, Bankart J, Morgan M D, et al. Dichloroacetate enhances    performance and reduces blood lactate during maximal cycle exercise    in chronic obstructive pulmonary disease. Am J Respir Crit Care Med.    2008 May 15; 177(10):1090-4.-   non-patent document 27: Flavin D F. Non-Hodgkin's Lymphoma Reversal    with Dichloroacetate. J Oncol. Hindawi Publishing Corporation    Journal of Oncology, Volume 2010, Article ID 414726, 4 pages    doi:10.1155/2010/414726.

SUMMARY OF THE INVENTION

The present invention is as follow.

[1] A compound represented by the formula [I]:

wherein n is 1 or 2,or a pharmaceutically acceptable salt thereof,[2] a compound represented by the formula:

[3] the compound of the above-mentioned [2], which is represented by theformula [II]:

[4] the compound of the above-mentioned [2], which is represented by theformula [IIh]:

[5] a compound represented by the formula [III]:

[6] a pharmaceutical composition comprising the compound of any of theabove-mentioned [1] to [5], or a pharmaceutically acceptable saltthereof, and a pharmaceutically acceptable carrier,[7] a PDHK inhibitor comprising the compound of any of theabove-mentioned [1] to [5], or a pharmaceutically acceptable saltthereof,[8] a PDHK1 inhibitor comprising the compound of any of theabove-mentioned [1] to [5], or a pharmaceutically acceptable saltthereof,[9] a PDHK2 inhibitor comprising the compound of any of theabove-mentioned [1] to [5], or a pharmaceutically acceptable saltthereof,[10] a hypoglycemic agent comprising the compound of any of theabove-mentioned [1] to [5], or a pharmaceutically acceptable saltthereof,[11] a lactic acid-lowering agent comprising the compound of any of theabove-mentioned [1] to [5], or a pharmaceutically acceptable saltthereof,[12] an agent for the prophylaxis or treatment of diabetes, insulinresistance syndrome, metabolic syndrome, hyperglycemia,hyperlactacidemia, diabetic complications, cardiac failure,cardiomyopathy, myocardial ischemia, myocardial infarction, anginapectoris, dyslipidemia, atherosclerosis, peripheral arterial disease,intermittent claudication, chronic obstructive pulmonary disease, brainischemia, cerebral apoplexy, mitochondrial disease, mitochondrialencephalomyopathy, cancer or pulmonary hypertension, which comprises thecompound of any of the above-mentioned [1] to [5], or a pharmaceuticallyacceptable salt thereof, [12′] an agent for the prophylaxis or treatmentof diabetes, insulin resistance syndrome, metabolic syndrome,hyperglycemia, hyperlactacidemia, diabetic complications, cardiacfailure, cardiomyopathy, myocardial ischemia, myocardial infarction,angina pectoris, dyslipidemia, atherosclerosis, peripheral arterialdisease, intermittent claudication, chronic obstructive pulmonarydisease, brain ischemia, cerebral apoplexy, mitochondrial disease,mitochondrial encephalomyopathy, cancer, pulmonary hypertension orAlzheimer disease, which comprises the compound of any of theabove-mentioned [1] to [5], or a pharmaceutically acceptable saltthereof,[13] the prophylactic or therapeutic agent of the above-mentioned [12],wherein the diabetes is type 1 diabetes or type 2 diabetes,[14] the prophylactic or therapeutic agent of the above-mentioned [12],wherein the diabetic complications are selected from the groupconsisting of diabetic neuropathy, diabetic retinopathy, diabeticnephropathy and cataract,[15] the prophylactic or therapeutic agent of the above-mentioned [12],wherein the cardiac failure is acute cardiac failure or chronic cardiacfailure,[16] a pharmaceutical composition comprising(a) the compound of any of the above-mentioned [1] to [5], or apharmaceutically acceptable salt thereof, and(b) at least one other medicament effective for the prophylaxis ortreatment of a disease selected from the group consisting of diabetes(type 1 diabetes, type 2 diabetes), insulin resistance syndrome,metabolic syndrome, hyperglycemia, hyperlactacidemia, diabeticcomplications (diabetic neuropathy, diabetic retinopathy, diabeticnephropathy, cataract), cardiac failure (acute cardiac failure, chroniccardiac failure), cardiomyopathy, myocardial ischemia, myocardialinfarction, angina pectoris, dyslipidemia, atherosclerosis, peripheralarterial disease, intermittent claudication, chronic obstructivepulmonary diseases, brain ischemia, cerebral apoplexy, mitochondrialdisease, mitochondrial encephalomyopathy, cancer and pulmonaryhypertension,[16′] a pharmaceutical composition comprising(a) the compound of any of the above-mentioned [1] to [5], or apharmaceutically acceptable salt thereof, and(b) at least one other medicament effective for the prophylaxis ortreatment of a disease selected from the group consisting of diabetes(type 1 diabetes, type 2 diabetes), insulin resistance syndrome,metabolic syndrome, hyperglycemia, hyperlactacidemia, diabeticcomplications (diabetic neuropathy, diabetic retinopathy, diabeticnephropathy, cataract), cardiac failure (acute cardiac failure, chroniccardiac failure), cardiomyopathy, myocardial ischemia, myocardialinfarction, angina pectoris, dyslipidemia, atherosclerosis, peripheralarterial disease, intermittent claudication, chronic obstructivepulmonary diseases, brain ischemia, cerebral apoplexy, mitochondrialdisease, mitochondrial encephalomyopathy, cancer, pulmonary hypertensionand Alzheimer disease,[17] a combination drug comprising(a) the compound of any of the above-mentioned [1] to [5], or apharmaceutically acceptable salt thereof, and(b) at least one other medicament effective for the prophylaxis ortreatment of a disease selected from the group consisting of diabetes(type 1 diabetes, type 2 diabetes), insulin resistance syndrome,metabolic syndrome, hyperglycemia, hyperlactacidemia, diabeticcomplications (diabetic neuropathy, diabetic retinopathy, diabeticnephropathy, cataract), cardiac failure (acute cardiac failure, chroniccardiac failure), cardiomyopathy, myocardial ischemia, myocardialinfarction, angina pectoris, dyslipidemia, atherosclerosis, peripheralarterial disease, intermittent claudication, chronic obstructivepulmonary disease, brain ischemia, cerebral apoplexy, mitochondrialdisease, mitochondrial encephalomyopathy, cancer and pulmonaryhypertension, which are administered simultaneously, separately orcontinuously.[17′] a combination drug comprising(a) the compound of any of the above-mentioned [1] to [5], or apharmaceutically acceptable salt thereof, and(b) at least one other medicament effective for the prophylaxis ortreatment of a disease selected from the group consisting of diabetes(type 1 diabetes, type 2 diabetes), insulin resistance syndrome,metabolic syndrome, hyperglycemia, hyperlactacidemia, diabeticcomplications (diabetic neuropathy, diabetic retinopathy, diabeticnephropathy, cataract), cardiac failure (acute cardiac failure, chroniccardiac failure), cardiomyopathy, myocardial ischemia, myocardialinfarction, angina pectoris, dyslipidemia, atherosclerosis, peripheralarterial disease, intermittent claudication, chronic obstructivepulmonary disease, brain ischemia, cerebral apoplexy, mitochondrialdisease, mitochondrial encephalomyopathy, cancer, pulmonary hypertensionand Alzheimer disease, which are administered simultaneously, separatelyor continuously.[18] a method of inhibiting PDHK in a mammal, comprising administering apharmaceutically effective amount of the compound of any of theabove-mentioned [1] to [5], or a pharmaceutically acceptable saltthereof to said mammal,[19] a method of inhibiting PDHK1 in a mammal, comprising administeringa pharmaceutically effective amount of the compound of any of theabove-mentioned [1] to [5], or a pharmaceutically acceptable saltthereof to said mammal,[20] a method of inhibiting PDHK2 in a mammal, comprising administeringa pharmaceutically effective amount of the compound of any of theabove-mentioned [1] to [5], or a pharmaceutically acceptable saltthereof to said mammal,[21] a method for the prophylaxis or treatment of diabetes (type 1diabetes, type 2 diabetes), insulin resistance syndrome, metabolicsyndrome, hyperglycemia, hyperlactacidemia, diabetic complications(diabetic neuropathy, diabetic retinopathy, diabetic nephropathy,cataract), cardiac failure (acute cardiac failure, chronic cardiacfailure), cardiomyopathy, myocardial ischemia, myocardial infarction,angina pectoris, dyslipidemia, atherosclerosis, peripheral arterialdisease, intermittent claudication, chronic obstructive pulmonarydisease, brain ischemia, cerebral apoplexy, mitochondrial disease,mitochondrial encephalomyopathy, cancer or pulmonary hypertension in amammal, comprising administering a pharmaceutically effective amount ofthe compound of any of the above-mentioned [1] to [5], or apharmaceutically acceptable salt thereof to said mammal,[21′] a method for the prophylaxis or treatment of diabetes (type 1diabetes, type 2 diabetes), insulin resistance syndrome, metabolicsyndrome, hyperglycemia, hyperlactacidemia, diabetic complications(diabetic neuropathy, diabetic retinopathy, diabetic nephropathy,cataract), cardiac failure (acute cardiac failure, chronic cardiacfailure), cardiomyopathy, myocardial ischemia, myocardial infarction,angina pectoris, dyslipidemia, atherosclerosis, peripheral arterialdisease, intermittent claudication, chronic obstructive pulmonarydisease, brain ischemia, cerebral apoplexy, mitochondrial disease,mitochondrial encephalomyopathy, cancer, pulmonary hypertension orAlzheimer disease in a mammal, comprising administering apharmaceutically effective amount of the compound of any of theabove-mentioned [1] to [5], or a pharmaceutically acceptable saltthereof to said mammal,[22] a method of decreasing the blood glucose level in a mammal,comprising administering a pharmaceutically effective amount of thecompound of any of the above-mentioned [1] to [5], or a pharmaceuticallyacceptable salt thereof to said mammal,[23] a method of decreasing the lactate level in a mammal, comprisingadministering a pharmaceutically effective amount of the compound of anyof the above-mentioned [1] to [5], or a pharmaceutically acceptable saltthereof to said mammal,[24] use of the compound of any of the above-mentioned [1] to [5], or apharmaceutically acceptable salt thereof for the production of a PDHKinhibitor,[25] use of the compound of any of the above-mentioned [1] to [5], or apharmaceutically acceptable salt thereof for the production of a PDHK1inhibitor,[26] use of the compound of any of the above-mentioned [1] to [5], or apharmaceutically acceptable salt thereof for the production of a PDHK2inhibitor,[27] use of the compound of any of the above-mentioned [1] to [5], or apharmaceutically acceptable salt thereof for the production of a bloodglucose level-lowering agent,[28] use of the compound of any of the above-mentioned [1] to [5], or apharmaceutically acceptable salt thereof for the production of a lactatelevel-lowering agent,[29] use of the compound of any of the above-mentioned [1] to [5], or apharmaceutically acceptable salt thereof for the production of aprophylactic or therapeutic agent for diabetes (type 1 diabetes, type 2diabetes), insulin resistance syndrome, metabolic syndrome,hyperglycemia, hyperlactacidemia, diabetic complications (diabeticneuropathy, diabetic retinopathy, diabetic nephropathy, cataract),cardiac failure (acute cardiac failure, chronic cardiac failure),cardiomyopathy, myocardial ischemia, myocardial infarction, anginapectoris, dyslipidemia, atherosclerosis, peripheral arterial disease,intermittent claudication, chronic obstructive pulmonary disease, brainischemia, cerebral apoplexy, mitochondrial disease, mitochondrialencephalomyopathy, cancer or pulmonary hypertension,[29′] use of the compound of any of the above-mentioned [1] to [5], or apharmaceutically acceptable salt thereof for the production of aprophylactic or therapeutic agent for diabetes (type 1 diabetes, type 2diabetes), insulin resistance syndrome, metabolic syndrome,hyperglycemia, hyperlactacidemia, diabetic complications (diabeticneuropathy, diabetic retinopathy, diabetic nephropathy, cataract),cardiac failure (acute cardiac failure, chronic cardiac failure),cardiomyopathy, myocardial ischemia, myocardial infarction, anginapectoris, dyslipidemia, atherosclerosis, peripheral arterial disease,intermittent claudication, chronic obstructive pulmonary disease, brainischemia, cerebral apoplexy, mitochondrial disease, mitochondrialencephalomyopathy, cancer, pulmonary hypertension or Alzheimer disease,[30] the use of any of the above-mentioned [24] to [29], in combinationwith at least one other medicament effective for the prophylaxis ortreatment of a disease selected from the group consisting of diabetes(type 1 diabetes, type 2 diabetes), insulin resistance syndrome,metabolic syndrome, hyperglycemia, hyperlactacidemia, diabeticcomplications (diabetic neuropathy, diabetic retinopathy, diabeticnephropathy, cataract), cardiac failure (acute cardiac failure, chroniccardiac failure), cardiomyopathy, myocardial ischemia, myocardialinfarction, angina pectoris, dyslipidemia, atherosclerosis, peripheralarterial disease, intermittent claudication, chronic obstructivepulmonary disease, brain ischemia, cerebral apoplexy, mitochondrialdisease, mitochondrial encephalomyopathy, cancer and pulmonaryhypertension, and[30′] the use of any of the above-mentioned [24] to [29], in combinationwith at least one other medicament effective for the prophylaxis ortreatment of a disease selected from the group consisting of diabetes(type 1 diabetes, type 2 diabetes), insulin resistance syndrome,metabolic syndrome, hyperglycemia, hyperlactacidemia, diabeticcomplications (diabetic neuropathy, diabetic retinopathy, diabeticnephropathy, cataract), cardiac failure (acute cardiac failure, chroniccardiac failure), cardiomyopathy, myocardial ischemia, myocardialinfarction, angina pectoris, dyslipidemia, atherosclerosis, peripheralarterial disease, intermittent claudication, chronic obstructivepulmonary disease, brain ischemia, cerebral apoplexy, mitochondrialdisease, mitochondrial encephalomyopathy, cancer, pulmonary hypertensionand Alzheimer disease, and the like.

Effect of the Invention

The compound of the present invention or a pharmaceutically acceptablesalt thereof inhibits a PDHK activity, and is useful as a therapeutic orprophylactic agent for diabetes (type 1 diabetes, type 2 diabetes),insulin resistance syndrome, metabolic syndrome, hyperglycemia,hyperlactacidemia, diabetic complications (diabetic neuropathy, diabeticretinopathy, diabetic nephropathy, cataract), cardiac failure (acutecardiac failure, chronic cardiac failure), cardiomyopathy, myocardialischemia, myocardial infarction, angina pectoris, dyslipidemia,atherosclerosis, peripheral arterial disease, intermittent claudication,chronic obstructive pulmonary disease, brain ischemia, cerebralapoplexy, mitochondrial disease, mitochondrial encephalomyopathy,cancer, pulmonary hypertension or Alzheimer disease, and the like.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows an effect of test compounds on the liver PDH activity(percentage of active liver PDH activity to the total liver PDHactivity) in non-fasting SD(IGS) rats (mean±standard deviation (n=3)).

FIG. 2 shows an effect of test compounds on the adipose tissue PDHactivity (percentage of active adipose tissue PDH activity to the totaladipose tissue PDH activity) in non-fasting SD(IGS) rats (mean±standarddeviation (n=3)).

DESCRIPTION OF EMBODIMENTS

The present invention is explained in detail in the following.

The compound of the present invention is a compound represented by theformula [I]:

wherein n is 1 or 2,(hereinafter to be also referred to as compound (1)), or apharmaceutically acceptable salt thereof.

The compound of the present invention is a compound represented by theformula [II]:

(2-{4-[(9R)-9-hydroxy-2-(3-hydroxy-3-methylbutyloxy)-9-(trifluoromethyl)-9H-fluoren-4-yl]-1H-pyrazol-1-yl}-2-methylpropanamide)(hereinafter to be also referred to as compound (2)).

The compound of the present invention is a compound represented by theformula [IIh]:

(2-{4-[(9R)-9-hydroxy-2-(3-hydroxy-3-methylbutyloxy)-9-(trifluoromethyl)-9H-fluoren-4-yl]-1H-pyrazol-1-yl}-2-methylpropanamidemonohydrate) (hereinafter to be also referred to as compound (2h)).

The compound of the present invention is a compound represented by theformula [III]:

(2-{4-[(9R)-9-hydroxy-2-(4-hydroxy-4-methylpentyloxy)-9-(trifluoromethyl)-9H-fluoren-4-yl]-1H-pyrazol-1-yl}-2-methylpropanamide)(hereinafter to be also referred to as compound (3)).

A pharmaceutically acceptable salt of the compound of the presentinvention may be any salt as long as it forms a nontoxic salt with thecompound of the present invention. Examples thereof include salts withinorganic acids, salts with organic acids, salts with amino acids andthe like.

Examples of the salt with inorganic acid include a salt withhydrochloric acid, nitric acid, sulfuric acid, phosphoric acid,hydrobromic acid and the like.

Examples of the salt with organic acid include salts with oxalic acid,maleic acid, citric acid, fumaric acid, lactic acid, malic acid,succinic acid, tartaric acid, acetic acid, trifluoroacetic acid,gluconic acid, ascorbic acid, methanesulfonic acid, benzenesulfonicacid, p-toluenesulfonic acid and the like.

Examples of the salt with amino acid include salts with lysine,arginine, aspartic acid, glutamic acid and the like.

A pharmaceutically acceptable salt of the compound of the presentinvention is preferably a salt with an inorganic acid.

In addition, the compound of the present invention or a pharmaceuticallyacceptable salt thereof may be labeled with an isotope (e.g., ³H, ¹⁴C,³⁵S etc.).

As the compound of the present invention or a pharmaceuticallyacceptable salt thereof, compound (1) or a pharmaceutically acceptablesalt thereof, each of which is substantially purified, is preferable.More preferred is the compound of the present invention or apharmaceutically acceptable salt thereof, each of which is purified to apurity of not less than 80%.

The compound of the formula [I] or a pharmaceutically acceptable saltthereof may exist as a solvate. The term “solvate” refers to thecompound of the formula [I] or a pharmaceutically acceptable saltthereof with which a solvent molecule is associated, and also includeshydrates. Such solvates are preferably pharmaceutically acceptablesolvates. Such solvates include, for example, hydrate, ethanol solvate,dimethylsulfoxide-solvate and the like of the compound of the formula[I] or a pharmaceutically acceptable salt thereof. Specific examplesinclude hemihydrate, monohydrate, dihydrate or mono(ethanol)solvate ofthe compound of the formula [I] or a monohydrate of the compound of theformula [I], 2/3 (ethanol)solvate of dihydrochloride of the same and thelike. Such solvates can be produced according to conventional methods.

Examples of the “pharmaceutical composition” include oral preparationssuch as tablet, capsule, granule, powder, troche, syrup, emulsion,suspension and the like, and parenteral agents such as externalpreparation, suppository, injection, eye drop, nasal preparation,pulmonary preparation and the like.

The pharmaceutical composition of the present invention is producedaccording to a method known per se in the art of pharmaceuticalpreparations, by mixing the compound of the present invention or apharmaceutically acceptable salt thereof with a suitable amount of atleast one kind of pharmaceutically acceptable carrier and the like asappropriate. While the content of the compound of the present inventionor a pharmaceutically acceptable salt thereof in the pharmaceuticalcomposition varies depending on the dosage form, dose and the like, itis, for example, 0.1 to 100 wt % of the whole composition.

Examples of the “pharmaceutically acceptable carrier” include variousorganic or inorganic carrier substances conventionally used aspreparation materials, for example, excipient, disintegrant, binder,fluidizer, lubricant and the like for solid preparations, and solvent,solubilizing agent, suspending agent, isotonicity agent, bufferingagent, soothing agent and the like for liquid preparations. Wherenecessary, moreover, additives such as preservative, antioxidant,colorant, sweetening agent and the like are used.

Examples of the “excipient” include lactose, sucrose, D-mannitol,D-sorbitol, cornstarch, dextrin, microcrystalline cellulose, crystallinecellulose, carmellose, carmellose calcium, sodium carboxymethyl starch,low-substituted hydroxypropylcellulose, gum arabic and the like.

Examples of the “disintegrant” include carmellose, carmellose calcium,carmellose sodium, sodium carboxymethyl starch, croscarmellose sodium,crospovidone, low-substituted hydroxypropylcellulose,hydroxypropylmethylcellulose, crystalline cellulose and the like.

Examples of the “binder” include hydroxypropylcellulose,hydroxypropylmethylcellulose, povidone, crystalline cellulose, sucrose,dextrin, starch, gelatin, carmellose sodium, gum arabic and the like.

Examples of the “fluidizer” include light anhydrous silicic acid,magnesium stearate and the like.

Examples of the “lubricant” include magnesium stearate, calciumstearate, talc and the like.

Examples of the “solvent” include purified water, ethanol, propyleneglycol, macrogol, sesame oil, corn oil, olive oil and the like.

Examples of the “solubilizing agents” include propylene glycol,D-mannitol, benzyl benzoate, ethanol, triethanolamine, sodium carbonate,sodium citrate and the like.

Examples of the “suspending agent” include benzalkonium chloride,carmellose, hydroxypropylcellulose, propylene glycol, povidone,methylcellulose, glycerol monostearate and the like.

Examples of the “isotonic agent” include glucose, D-sorbitol, sodiumchloride, D-mannitol and the like.

Examples of the “buffering agent” include sodium hydrogenphosphate,sodium acetate, sodium carbonate, sodium citrate and the like.

Examples of the “soothing agent” include benzyl alcohol and the like.

Examples of the “preservative” include ethyl parahydroxybenzoate,chlorobutanol, benzyl alcohol, sodium dehydroacetate, sorbic acid andthe like.

Examples of the “antioxidant” include sodium sulfite, ascorbic acid andthe like.

Examples of the “colorant” include food colors (e.g., Food Color Red No.2 or 3, Food Color yellow No. 4 or 5 etc.), 3-carotene and the like.

Examples of the “sweetening agent” include saccharin sodium, dipotassiumglycyrrhizinate, aspartame and the like.

The pharmaceutical composition of the present invention can beadministered orally or parenterally (e.g., topical, intramuscular,subcutaneous, rectal, intravenous administration etc.) to human as wellas mammals other than human (e.g., mouse, rat, hamster, guinea pig,rabbit, cat, dog, swine, bovine, horse, sheep, monkey etc.). The dosevaries depending on the subject of administration, disease, symptom,dosage form, administration route and the like. For example, the dailydose for oral administration to an adult patient (body weight: about 60kg) is generally within the range of about 1 mg to 1 g, based oncompound (1) as the active ingredient. This amount can be administeredin one to several portions.

Since the compound of the present invention or a pharmaceuticallyacceptable salt thereof has a PDHK (PDHK1 and/or PDHK2) inhibitoryactivity, it is considered to be advantageous for the treatment orprophylaxis of the diseases relating to an impairment of glucoseutilization, for example, diabetes (type 1 diabetes, type 2 diabetesetc.), insulin resistance syndrome, metabolic syndrome, hyperglycemia,hyperlactacidemia, diabetic complications (diabetic neuropathy, diabeticretinopathy, diabetic nephropathy, cataract etc.). In addition, the PDHKinhibitor is considered to be advantageous for the treatment orprophylaxis of diseases wherein supply of an energy substrate to atissue is limited, for example, cardiac failure (acute cardiac failure,chronic cardiac failure), cardiomyopathy, myocardial ischemia,myocardial infarction, angina pectoris, dyslipidemia, atherosclerosis,peripheral arterial disease, intermittent claudication, chronicobstructive pulmonary disease, brain ischemia and cerebral apoplexy.Furthermore, the PDHK inhibitor is considered to be advantageous for thetreatment or prophylaxis of a mitochondrial disease, mitochondrialencephalomyopathy, cancer pulmonary hypertension or Alzheimer disease,and the like.

Diabetes is, for example, type 1 diabetes or type 2 diabetes.

Examples of the diabetic complications include diabetic neuropathy,diabetic retinopathy, diabetic nephropathy and cataract.

Cardiac failure is, for example, acute cardiac failure or chroniccardiac failure.

To “inhibit PDHK” means to inhibit the function of PDHK and eliminate orattenuate the activity. To “inhibit PDHK”, human PDHK is preferablyinhibited. As a “PDHK inhibitor”, preferred is a “human PDHK inhibitor”.

To “inhibit PDHK1” means to inhibit the function of PDHK1 and eliminateor attenuate the activity. For example, it means to inhibit the functionas PDHK1 based on the conditions in the below-mentioned ExperimentalExample 1. To “inhibit PDHK1”, human PDHK1 is preferably inhibited. As a“PDHK1 inhibitor”, preferred is a “human PDHK1 inhibitor”. Morepreferred is a “PDHK1 inhibitor for human target organ”.

To “inhibit PDHK2” means to inhibit the function of PDHK2 and eliminateor attenuate the activity. For example, it means to inhibit the functionas PDHK2 based on the conditions in the below-mentioned ExperimentalExample 1. To “inhibit PDHK2”, human PDHK2 is preferably inhibited. As a“PDHK2 inhibitor”, preferred is a “human PDHK2 inhibitor”. Morepreferred is a “PDHK2 inhibitor for human target organ”.

To “activate PDH” means to activate PDH in a target organ (e.g., liver,skeletal muscle, adipose tissue, heart, brain) and the like, cancer orthe like.

To “decrease blood glucose level” means to decrease the glucoseconcentration in blood (including in serum and plasma), preferably todecrease high blood glucose level, more preferably, to decrease theblood glucose level to a therapeutically effective normal level forhuman.

To “decrease lactic acid level” means to decrease the lactic acidconcentration in blood (including in serum and plasma), preferably todecrease high lactic acid level, more preferably, to decrease the lacticacid level to a therapeutically effective normal level for human.

The compound of the present invention or a pharmaceutically acceptablesalt thereof can be used in combination with one or a plurality of othermedicaments (hereinafter to be also referred to as a concomitant drug)according to a method generally employed in the medical field(hereinafter to be referred to as combined use).

The administration period of the compound of the present invention or apharmaceutically acceptable salt thereof, and a concomitant drug is notlimited, and they may be administered to an administration subject ascombination preparation, or the both preparations may be administeredsimultaneously or at given intervals. In addition, the pharmaceuticalcomposition of the present invention and a concomitant drug may be usedas a medicament in the form of a kit. The dose of the concomitant drugis similar to the clinically-employed dose and can be appropriatelyselected according to the subject of administration, disease, symptom,dosage form, administration route, administration time, combination andthe like. The administration form of the concomitant drug is notparticularly limited, and it only needs to be combined with the compoundof the present invention or a pharmaceutically acceptable salt thereof.

Examples of the combination drug include therapeutic agents and/orprophylaxis agents for diabetes (type 1 diabetes, type 2 diabetes etc.),insulin resistance syndrome, metabolic syndrome, hyperglycemia,hyperlactacidemia, diabetic complications (diabetic neuropathy, diabeticretinopathy, diabetic nephropathy, cataract), cardiac failure (acutecardiac failure, chronic cardiac failure), cardiomyopathy, myocardialischemia, myocardial infarction, angina pectoris, dyslipidemia,atherosclerosis, peripheral arterial disease, intermittent claudication,chronic obstructive pulmonary disease, brain ischemia, cerebralapoplexy, mitochondrial disease, mitochondrial encephalomyopathy,cancer, pulmonary hypertension or Alzheimer disease, and the like, andone or more agents therefrom and the compound of the present inventionor a pharmaceutically acceptable salt thereof can be used incombination.

Examples of the “agent for the treatment and/or prophylaxis of diabetes”include insulin preparation, sulfonylurea hypoglycemic agent, metformin,DPP-4 inhibitor, insulin resistance improving agent (for example,thiazolidine derivative), GLP-1 receptor agonist and the like.

EXAMPLES

The production method of the compound of the present invention or apharmaceutically acceptable salt thereof is specifically explained byExamples. However, the present invention is not limited by theseExamples.

Even if no description is found in the present production method, stepsmay be modified for efficient production, such as introduction of aprotecting group into a functional group where necessary withdeprotection in a subsequent step, using a functional group as aprecursor in each step, followed by conversion to a desired functionalgroup at a suitable stage, changing the order of production methods andsteps, and the like.

The treatment after reaction in each step may be performed by aconventional method, where isolation and purification can be performedas necessary according to a method appropriately selected fromconventional methods such as crystallization, recrystallization,distillation, partitioning, silica gel chromatography, preparative HPLCand the like, or a combination thereof. All reagents and solvents havequality of commercially available products, and were used withoutpurification.

Percentage % shows wt %. Other abbreviations used in the example sectionmean the following.

-   -   s: singlet    -   d: doublet    -   t: triplet    -   q: quartet    -   m: multiplet    -   br: broad    -   dd: double doublet    -   td: triple doublet    -   ddd: double double doublet    -   J: coupling constant    -   CDCl₃: deuterated chloroform    -   DMSO-D₆: deuterated dimethyl sulfoxide    -   ¹H NMR: proton nuclear magnetic resonance    -   HPLC: high performance liquid chromatography    -   DPPA: diphenylphosphoryl azide    -   ¹H-NMR spectrum was measured in CDCl₃ or DMSO-D₆ using        tetramethylsilane as an internal standard, and all δ values are        shown in ppm.

(10 mM Phosphate Buffer (pH 2.0))

Sodium dihydrogen phosphate (3.60 g) was dissolved in water (3000 ml),and adjusted to pH 2.0 with phosphoric acid to give the title buffer.

HPLC Analysis Conditions Analysis Condition 1

Measurement device: HPLC system SHIMADZU CORPORATION high-performanceliquid chromatograph ProminenceColumn: DAICEL CHIRALCEL OD-3R 4.6 mmϕ×150 mmColumn temperature: 40° C.Mobile phase: (SOLUTION A) 10 mM phosphate buffer (pH 2.0), (SOLUTION B)acetonitrileThe composition of the mobile phase (SOLUTION A:SOLUTION B) was linearlychanged from 50:50 to 20:80 over 20 min and then maintained at 20:80 for5 min.Flow rate: 0.5 ml/min

Detection: UV (220 nm) Analysis Condition 2

Measurement device: HPLC system SHIMADZU CORPORATION high-performanceliquid chromatograph ProminenceColumn: DAICEL CHIRALCEL OJ-RH 4.6 mmϕ×150 mmColumn temperature: 40° C.Mobile phase: (SOLUTION A) 10 mM phosphate buffer (pH 2.0),(SOLUTION B) acetonitrileThe composition of the mobile phase (SOLUTION A:SOLUTION B) was linearlychanged from 70:30 to 40:60 over 20 min and then maintained at 40:60 for10 min.Flow rate: 0.5 ml/min

Detection: UV (220 nm) Analysis Condition 3

Measurement device: HPLC system SHIMADZU CORPORATION high-performanceliquid chromatograph ProminenceColumn: DAICEL CHIRALPAK AD-3R 4.6 mmϕ×150 mmColumn temperature: 40° C.Mobile phase: (SOLUTION A) 10 mM phosphate buffer (pH 2.0), (SOLUTION B)acetonitrileThe composition of the mobile phase (SOLUTION A:SOLUTION B) was linearlychanged from 50:50 to 20:80 over 20 min and then maintained at 20:80 for5 min.Flow rate: 0.5 ml/min

Detection: UV (220 nm) Example 1 Synthesis of2-{4-[(9R)-9-hydroxy-2-(3-hydroxy-3-methylbutyloxy)-9-(trifluoromethyl)-9H-fluoren-4-yl]-1H-pyrazol-1-yl}-2-methylpropanamide(Compound (2)) Step 1 Ethyl 2′-chloro-4′-methoxybiphenyl-2-carboxylate

Under an argon atmosphere, 1-bromo-2-chloro-4-methoxybenzene (44.3 g)was dissolved in toluene (220 ml), ethyl2-(4,4,5,5-tetramethyl[1,3,2]dioxaborolan-2-yl)benzoate (60.8 g), water(132 ml), sodium hydrogen carbonate (33.6 g) anddichlorobis(triphenylphosphine)palladium(II) (2.8 g) were added, and themixture was stirred at an oil bath temperature of 120° C. for 7 hr. Tothe reaction mixture was added ethyl2-(4,4,5,5-tetramethyl[1,3,2]dioxaborolan-2-yl)benzoate (5.2 g), and themixture was further stirred for 2 hr. The reaction mixture was cooled toroom temperature, toluene (100 ml) and water (200 ml) were added, andthe mixture was stirred overnight. To the reaction mixture was addedactivated carbon (3 g), and the mixture was further stirred for 1 hr.The insoluble material was filtered off through celite, and theinsoluble material was washed with toluene (100 ml) and water (200 ml).The obtained filtrates were combined to allow for layer separation. Theobtained organic layer was washed with water (100 ml), and the solventwas evaporated to give the title compound (67.7 g).

¹H-NMR (400 MHz, DMSO-D₆) δ: 7.88-7.86 (1H, m), 7.63 (1H, td, J=7.6, 1.4Hz), 7.51 (1H, td, J=7.6, 1.4 Hz), 7.27 (1H, dd, J=7.6, 0.9 Hz), 7.18(1H, d, J=8.6 Hz), 7.06 (1H, d, J=2.6 Hz), 6.95 (1H, dd, J=8.6, 2.6 Hz),4.01 (2H, m), 3.80 (3H, s), 0.96 (3H, t, J=7.1 Hz).

Step 2 2′-Chloro-4′-methoxybiphenyl-2-carboxylic acid

Ethyl 2′-chloro-4′-methoxybiphenyl-2-carboxylate (67.7 g) was dissolvedin ethanol (100 ml), 4N aqueous sodium hydroxide (100 ml) was added, andthe mixture was stirred at an oil bath temperature of 110° C. for 4.5hr. The reaction mixture was cooled to room temperature, water (200 ml)and toluene (100 ml) were added, and the mixture was stirred overnight.To the reaction mixture was added activated carbon (3.6 g), and themixture was further stirred for 1 hr. The insoluble material wasfiltered off through celite, and the insoluble material was washed withtoluene (30 ml) and water (300 ml). The obtained filtrates were combinedto allow for layer separation. The obtained aqueous layer was washedwith toluene (100 ml), the aqueous layer was acidified with concentratedhydrochloric acid (40 ml), and stirred at room temperature for 1 hr. Theprecipitated solid was collected by filtration. The obtained solid wasair-dried for 3 hr, and dried under reduced pressure at 60° C. overnightto give the title compound (50.2 g)

¹H-NMR (400 MHz, DMSO-D₆) δ: 12.57 (1H, s), 7.90-7.88 (1H, m), 7.60 (1H,td, J=7.6, 1.3 Hz), 7.49 (1H, td, J=7.6, 1.3 Hz), 7.24 (1H, dd, J=7.6,1.0 Hz), 7.19 (1H, d, J=8.4 Hz), 7.06 (1H, d, J=2.4 Hz), 6.95 (1H, dd,J=8.5, 2.4 Hz), 3.81 (3H, s).

Step 3 4-Chloro-2-methoxy-9H-fluoren-9-one

Under an argon atmosphere, to 2′-chloro-4′-methoxybiphenyl-2-carboxylicacid (65.4 g) was added an Eaton reagent (phosphoruspentoxide-methanesulfonic acid (weight ratio 1:10) solution, 330 ml),and the mixture was stirred at an oil bath temperature of 100° C. for 1hr. The reaction mixture was ice-cooled, water (650 ml) was slowly addeddropwise, and the mixture was stirred at room temperature for 1 hr. Theprecipitated solid was collected by filtration, and washed with water(500 ml). The obtained solid was air-dried overnight to give the titlecompound (92.0 g).

¹H-NMR (400 MHz, DMSO-D₆) δ: 8.01 (1H, d, J=7.4 Hz), 7.64-7.60 (2H, m),7.36 (1H, td, J=7.4, 0.9 Hz), 7.17 (2H, dd, J=8.4, 2.3 Hz), 3.85 (3H,s).

Step 4 4-Chloro-2-hydroxy-9H-fluoren-9-one

Under an argon atmosphere, to 4-chloro-2-methoxy-9H-fluoren-9-one (92.0g) were added N-methylpyrrolidone (120 ml) and pyridine hydrochloride(144 g). The reaction mixture was stirred at an oil bath temperature of200° C. for 3 hr with removing water by a Dean-Stark apparatus. Thereaction mixture was cooled to 90° C., water (600 ml) was addeddropwise, and the mixture was stirred at room temperature for 2 hr. Theprecipitated solid was collected by filtration, and washed with water(400 ml). The obtained solid was air-dried for 3 days, a mixed solventof hexane and ethyl acetate (hexane:ethyl acetate 1:1, 300 ml) wasadded, and the mixture was stirred at room temperature for 1 hr. Thesolid was collected by filtration, and washed with a mixed solvent ofhexane and ethyl acetate (hexane:ethyl acetate=1:1, 500 ml). Theobtained solid was dried under reduced pressure at 50° C. for 3 hr togive the title compound (48.6 g).

¹H-NMR (400 MHz, DMSO-D₆) δ: 10.56 (1H, s), 7.96 (1H, d, J=8.4 Hz),7.61-7.57 (2H, m), 7.32 (1H, td, J=7.4, 0.9 Hz), 6.97 (1H, d, J=2.2 Hz),6.94 (1H, d, J=2.2 Hz).

Step 5 Ethyl 4-(4-chloro-9-oxo-9H-fluoren-2-yloxy)butyrate

4-Chloro-2-hydroxy-9H-fluoren-9-one (48.6 g) was dissolved inN,N-dimethylformamide (150 ml), potassium carbonate (58.3 g) and ethyl4-bromobutyrate (33.5 ml) were added, and the mixture was stirred at 60°C. for 2 hr. The reaction mixture was cooled to 40° C., and toluene (300ml) and water (300 ml) were added to allow for layer separation. Theobtained aqueous layer was extracted again with toluene (100 ml). Theobtained organic layers were combined, washed twice with water (100 ml),anhydrous sodium sulfate and activated carbon (2.5 g) were added, andthe mixture was stirred at room temperature for 5 min. The insolublematerial was filtered off through celite, and the solvent in thefiltrate was evaporated. To the obtained residue was added hexane (220ml), and the mixture was stirred at 50° C. for 10 min and at roomtemperature for 1 hr. The precipitated solid was collected byfiltration, and washed with hexane. The obtained solid was dried underreduced pressure to give the title compound (66.9 g). In addition, thesolvent in the obtained filtrate was evaporated, to the residue wereadded ethyl acetate (5 ml) and hexane (20 ml), and the mixture wasstirred at room temperature for 1 hr. The precipitated solid wascollected by filtration, and washed with hexane. The obtained solid wasdried under reduced pressure to further give the title compound (2.5 g).

¹H-NMR (400 MHz, DMSO-D₆) δ: 8.01 (1H, d, J=7.6 Hz), 7.65-7.61 (2H, m),7.37 (1H, t, J=7.6 Hz), 7.17-7.14 (2H, m), 4.13-4.05 (4H, m), 2.47 (2H,t, J=7.3 Hz), 2.02-1.95 (2H, m), 1.19 (3H, td, J=7.2, 0.7 Hz).

Step 6 Ethyl4-[(9R)-4-chloro-9-hydroxy-9-(trifluoromethyl)-9H-fluoren-2-yloxy]butyrate

Under an argon atmosphere, ethyl4-(4-chloro-9-oxo-9H-fluorene-2-yloxy)butyrate (69.4 g) was dissolved inTHF (700 ml), and N-(4-tert-butylbenzyl)cinchonidium 4-methoxyphenoxide(6.4 g) was added. To the reaction mixture was added dropwise a solutionof trimethyl(trifluoromethyl)silane (52.0 ml) in THF (140 ml) at −16°C., and the mixture was stirred at the same temperature for 15 min. Tothe reaction mixture were successively added acetic acid (23.0 ml) and1M tetrabutylammonium fluoride/THF solution (222 ml), and the mixturewas stirred at room temperature for 1 hr. The solvent in the reactionmixture was evaporated, and to the obtained residue were added toluene(500 ml) and saturated aqueous sodium hydrogen carbonate (200 ml) toallow for layer separation. The obtained organic layer was washedsuccessively with saturated aqueous sodium hydrogen carbonate (150 ml,twice), 1N aqueous sodium hydroxide (100 ml), water (100 ml), 1Nhydrochloric acid (100 ml), water (100 ml) and saturated brine (100 ml).To the obtained organic layer were added anhydrous magnesium sulfate andsilica gel (150 g), and the mixture was stirred for 10 min. Theinsoluble material was filtered off, and the insoluble material waswashed successively with toluene (300 ml) and ethyl acetate (800 ml).The obtained filtrate and the toluene washing were combined and thesolvent was evaporated to give the title compound (72.1 g). Also, thesolvent in the ethyl acetate washing was evaporated, to the obtainedresidue were added silica gel (40 g) and a mixed solvent of hexane andethyl acetate (ethyl acetate:hexane 2:1, 300 ml), and the mixture wasstirred at room temperature. The insoluble material was filtered off,and the insoluble material was washed with a mixed solvent of hexane andethyl acetate (ethyl acetate:hexane=2:1, 300 ml). The solvent in theobtained filtrate was evaporated to further give the title compound(20.3 g).

¹H-NMR (400 MHz, DMSO-D₆) δ: 8.14 (1H, d, J=7.7 Hz), 7.66 (1H, d, J=7.5Hz), 7.53 (1H, t, J=7.6 Hz), 7.42-7.38 (2H, m), 7.14 (2H, s), 4.11-4.05(4H, m), 2.47 (2H, t, J=7.5 Hz), 2.03-1.96 (2H, m), 1.19 (3H, td, J=7.1,0.8 Hz).

(Absolute Configuration)

Identification of the absolute configuration of4-chloro-2-methyl-9-(trifluoromethyl)-9H-fluoren-9-ol in theafter-mentioned step 10 confirmed that the title compound obtained inthis step is an (R) form. The optical purity was 52.9% e.e.

The optical purity was determined under the HPLC analysis condition 1.Retention time of (S) form 19.6 min, retention time of (R) form 23.0min.

Step 74-[(9R)-4-Chloro-9-hydroxy-9-(trifluoromethyl)-9H-fluoren-2-yloxy]butyricacid

Ethyl4-[(9R)-4-chloro-9-hydroxy-9-(trifluoromethyl)-9H-fluoren-2-yloxy]butyrate(92.2 g) was dissolved in ethanol (100 ml), 4N aqueous sodium hydroxide(100 ml) was added, and the mixture was stirred at 80° C. overnight. Thereaction mixture was cooled to room temperature, water (200 ml) wasadded, and the mixture was washed twice with toluene (100 ml). Theobtained aqueous layer was neutralized with concentrated hydrochloricacid (40 ml), and extracted twice with ethyl acetate (300 ml). Theobtained ethyl acetate extract was washed successively with water (100ml, twice), and saturated brine (100 ml), anhydrous magnesium sulfateand activated carbon (4.2 g) were added, and the mixture was stirred atroom temperature for 10 min. The insoluble material was filtered off,and the solvent in the filtrate was evaporated. To the obtained residuewas added chloroform (80 ml), and the mixture was heated to 50° C.Hexane (400 ml) was added dropwise, and the mixture was stirred at thesame temperature for 30 min, and at room temperature for 2 hr. Theprecipitated solid was collected by filtration, washed with a mixedsolvent of hexane and chloroform (hexane:chloroform=9:1, 50 ml), anddried under reduced pressure at 80° C. for 2 hr to give the titlecompound (72.5 g).

¹H-NMR (400 MHz, DMSO-D₆) δ: 12.17 (1H, br s), 8.14 (1H, d, J=7.7 Hz),7.66 (1H, d, J=7.5 Hz), 7.54 (1H, td, J=7.7, 1.2 Hz), 7.42-7.30 (2H, m),7.18-7.15 (2H, m), 4.09 (2H, t, J=6.4 Hz), 2.41 (2H, t, J=7.3 Hz),2.00-1.93 (2H, m).

Step 8 (1S)-1-(4-Methylphenyl)ethylamine salt of4-[(9R)-4-chloro-9-hydroxy-9-(trifluoromethyl)-9H-fluoren-2-yloxy]butyricacid

Under a nitrogen atmosphere, (1S)-1-(4-methylphenyl)ethylamine (19.5 g)was dissolved in ethyl acetate (720 ml), and4-[(9R)-4-chloro-9-hydroxy-9-(trifluoromethyl)-9H-fluoren-2-yloxy]butyricacid (72.5 g) was added. The reaction mixture was stirred at 60° C. for2 hr, and at room temperature overnight. The precipitated solid wascollected by filtration, and washed with ethyl acetate (100 ml). Theobtained solid was dried under reduced pressure at 60° C. for 5 hr togive the title compound (68.6 g). In addition,4-[(9S)-4-chloro-9-hydroxy-9-(trifluoromethyl)-9H-fluoren-2-yloxy]butyricacid could be obtained from the filtrate.

(Optical Purity)

The optical purity of4-[(9R)-4-chloro-9-hydroxy-9-(trifluoromethyl)-9H-fluoren-2-yloxy]butyricacid was determined under the HPLC analysis condition 1 (optical purity90.2% e.e.). Retention time of (R) form 12.9 min, retention time of (S)form 10.4 min.

¹H-NMR (400 MHz, DMSO-D₆) δ: 8.14 (1H, d, J=7.7 Hz), 7.66 (1H, d, J=7.7Hz), 7.53 (1H, td, J=7.6, 1.1 Hz), 7.40 (1H, td, J=7.6, 1.0 Hz), 7.26(2H, d, J=7.9 Hz), 7.16-7.10 (4H, m), 4.08 (2H, t, J=6.5 Hz), 4.01 (1H,q, J=6.7 Hz), 2.32 (2H, t, J=7.3 Hz), 2.26 (3H, s), 1.98-1.91 (2H, m),1.26 (3H, d, J=6.7 Hz).

Step 94-[(9R)-4-Chloro-9-hydroxy-9-(trifluoromethyl)-9H-fluoren-2-yloxy]butyricacid

To (1S)-1-(4-methylphenyl)ethylamine salt of4-[(9R)-4-chloro-9-hydroxy-9-(trifluoromethyl)-9H-fluoren-2-yloxy]butyricacid (68.6 g) were added ethyl acetate (500 ml) and 2N hydrochloric acid(300 ml), and the mixture was stirred at room temperature for 10 min.The mixture was allowed for layer separation. The obtained organic layerwas washed successively with water (250 ml) and saturated brine (200ml). The obtained organic layer was dried over anhydrous magnesiumsulfate, the insoluble material was filtered off, and the solvent in thefiltrate was evaporated to give the title compound (60.0 g).

¹H-NMR (400 MHz, DMSO-D₆) δ: 12.17 (1H, br s), 8.14 (1H, d, J=7.7 Hz),7.66 (1H, d, J=7.5 Hz), 7.54 (1H, td, J=7.7, 1.2 Hz), 7.42-7.30 (2H, m),7.18-7.15 (2H, m), 4.09 (2H, t, J=6.4 Hz), 2.41 (2H, t, J=7.3 Hz),2.00-1.93 (2H, m)

Step 10 (9R)-4-Chloro-9-(trifluoromethyl)-9H-fluorene-2,9-diol

To4-[(9R)-4-chloro-9-hydroxy-9-(trifluoromethyl)-9H-fluoren-2-yloxy]butyricacid (50 g) were added N-methylpyrrolidone (200 ml) and pyridinehydrochloride (298 g), and the mixture was stirred at an oil bathtemperature of 200° C. for 2 days. The reaction mixture was cooled toroom temperature, diluted with ethyl acetate (500 ml), and washed twicewith water. The obtained aqueous layer was extracted again with ethylacetate (300 ml). The combined organic layer was washed successivelywith water, 1N hydrochloric acid and saturated brine. To the obtainedorganic layer were added anhydrous magnesium sulfate and activatedcarbon (10 g), and the mixture was stirred at room temperature. Theinsoluble material was filtered off through celite. The solvent in theobtained organic layer was evaporated, hexane was added to the residue,and the mixture was stirred at room temperature. The precipitated solidwas collected by filtration, and dried under reduced pressure at roomtemperature. The obtained crude product was dissolved in ethyl acetate(500 ml), washed 3 times with water, dried over anhydrous magnesiumsulfate. The insoluble material was filtered off, and the solvent in thefiltrate was evaporated. To the residue was added hexane, and themixture was stirred at room temperature. The precipitated solid wascollected by filtration, dried under reduced pressure at roomtemperature to give the title compound (22.4 g).

¹H-NMR (400 MHz, DMSO-D₆) δ: 10.37 (1H, br s), 8.09 (1H, d, J=7.5 Hz),7.63 (1H, d, J=7.5 Hz), 7.50 (1H, td, J=7.6, 1.0 Hz), 7.36 (1H, td,J=7.6, 1.0 Hz), 7.32 (1H, br s), 7.06 (1H, s), 6.91 (1H, br d, J=2.0Hz).

(Absolute Configuration)

The absolute configuration of the title compound was determined by HPLCanalysis using the optically active column of compound (100A) andcompound (100B) prepared in the following steps (Step A-1 to Step A-2and Step B-1).

Step A-1

4-Chloro-2-methyl-9H-fluoren-9-one was subjected totrifluoromethylation, reaction with ethyl bromoacetate, and hydrolysisto give[4-chloro-2-methyl-9-(trifluoromethyl)-9H-fluorene-9-yloxy]acetic acid.This compound was optically resolved using (1R)-1-phenylethylamine, andthe absolute configuration was determined to be (R) by single crystalX-ray structural analysis of the obtained (1R)-1-phenylethylamine salt(100AA).

Step A-2

(9R)-4-Chloro-2-methyl-9-(trifluoromethyl)-9H-fluoren-9-ol (compound(100A)) was synthesized from compound 100AA by an acid treatment and thelike.

Step B-1

The hydroxyl group at the 2-position of4-chloro-9-(trifluoromethyl)-9H-fluorene-2,9-diol obtained in step 10was converted to a methyl group by the above-mentioned method to give4-chloro-2-methyl-9-(trifluoromethyl)-9H-fluoren-9-ol (compound (100B)).

(HPLC Analysis Using Optically Active Column)

Both enantiomers of compound (100) were separated by HPLC using anoptically active column (HPLC analysis condition 3). HPLC analysis ofcompound (100A) confirmed that the retention time of (R) form was 18.4min, and the retention time of (S) form was 17.0 min. Compound (100A)and compound (100B) were analyzed under the HPLC condition to find thatthe retention time matches.

It is considered that the absolute configuration of the asymmetriccarbon does not convert during the production of the above-mentionedcompound (100A) and compound (100B). The results have confirmed that4-chloro-9-(trifluoromethyl)-9H-fluorene-2,9-diol obtained in step 10has an absolute configuration of (R).

Step 11(9R)-4-Chloro-2-(3-hydroxy-3-methylbutyloxy)-9-(trifluoromethyl)-9H-fluoren-9-ol

Under a nitrogen atmosphere,(9R)-4-chloro-9-(trifluoromethyl)-9H-fluorene-2,9-diol (55.5 g) wasdissolved in N,N-dimethylformamide (550 ml), 3-hydroxy-3-methylbutyltoluene-4-sulfonate (49.6 g) and potassium carbonate (39.5 g) wereadded, and the mixture was stirred at an oil bath temperature of 70° C.overnight. To the reaction mixture was added a solution of3-hydroxy-3-methylbutyl toluene-4-sulfonate (4.0 g) inN,N-dimethylformamide (5 ml), and the mixture was further stirred at thesame temperature for 9.5 hr. The reaction mixture was ice-cooled, water(800 ml) was added, and the mixture was extracted with ethyl acetate(900 ml). The obtained organic layer was washed with water (500 ml, 3times) and saturated brine (500 ml). The obtained organic layer wasdried over anhydrous sodium sulfate, the insoluble material was filteredoff, and the solvent in the filtrate was evaporated. The obtainedresidue was purified by silica gel column chromatography (a mixture ofhexane and ethyl acetate was used as an elution solvent, first elutedwith a mixture of (hexane:ethyl acetate) at a mixing ratio 3:1, and thenwith the mixture at a mixing ratio 2:1, and further with the mixture ata mixing ratio 3:2) to give the title compound (49.5 g).

¹H-NMR (400 MHz, DMSO-D₆) δ: 8.12 (1H, d, J=7.6 Hz), 7.64 (1H, d, J=7.4Hz), 7.52 (1H, td, J=7.6, 0.9 Hz), 7.40-7.36 (2H, m), 7.15-7.13 (2H, m),4.41 (1H, s), 4.16 (2H, t, J=7.1 Hz), 1.85 (2H, t, J=7.1 Hz), 1.17 (6H,s).

Step 12 Ethyl2-{4-[(9R)-9-hydroxy-2-(3-hydroxy-3-methylbutyloxy)-9-(trifluoromethyl)-9H-fluoren-4-yl]-1H-pyrazol-1-yl}-2-methylpropionate

Under an argon atmosphere,(9R)-4-chloro-2-(3-hydroxy-3-methylbutyloxy)-9-(trifluoromethyl)-9H-fluoren-9-ol(49.5 g) was dissolved in toluene (445 ml), ethyl2-methyl-2-[4-(4,4,5,5-tetramethyl[1,3,2]dioxaborolan-2-yl)-1H-pyrazol-1-yl]propionate(59.2 g), water (149 ml), tripotassium phosphate (54.3 g), palladiumacetate (2.9 g) and 2-dicyclohexylphosphino-2′,6′-dimethoxybiphenyl(SPhos) (10.5 g) were added, and the mixture was stirred at an oil bathtemperature of 100° C. for 3.5 hr. The reaction mixture was cooled toroom temperature, and water (300 ml) was added. The insoluble materialwas filtered off through celite, and the insoluble material was washedwith toluene (150 ml) and water (50 ml). The obtained filtrates werecombined to allow for layer separation. The obtained organic layer waswashed successively with water (500 ml) and saturated brine (500 ml).The obtained organic layer was dried over anhydrous sodium sulfate, theinsoluble material was filtered off, and the solvent in the filtrate wasevaporated. The obtained residue was purified by silica gel columnchromatography (a mixture of hexane and ethyl acetate was used as anelution solvent, first eluted with a mixture of (hexane:ethyl acetate)at a mixing ratio 2:1, and then with the mixture at a mixing ratio 1:1,and further with the mixture at a mixing ratio 1:2), and furtherpurified by silica gel column chromatography (a mixture of hexane andacetone was used as an elution solvent, first eluted with a mixture of(hexane:acetone) at a mixing ratio 2:1, and then with the mixture atmixing ratios 4:1, 3:1, 2:1, 1:1, 2:3, and further with the mixture at amixing ratio 1:2) to give the title compound (68.4 g).

¹H-NMR (400 MHz, DMSO-D₆) δ: 8.18 (1H, s), 7.65 (1H, s), 7.59-7.57 (1H,m), 7.25-7.21 (4H, m), 7.13 (1H, br d, J=1.6 Hz), 6.84 (1H, d, J=2.3Hz), 4.38 (1H, s), 4.16-4.11 (4H, m), 1.86 (2H, t, J=7.1 Hz), 1.84 (6H,s), 1.16 (6H, s), 1.13 (3H, t, J=7.0 Hz).

Step 132-{4-[(9R)-9-Hydroxy-2-(3-hydroxy-3-methylbutyloxy)-9-(trifluoromethyl)-9H-fluoren-4-yl]-1H-pyrazol-1-yl}-2-methylpropionicacid

Ethyl2-{4-[(9R)-9-hydroxy-2-(3-hydroxy-3-methylbutyloxy)-9-(trifluoromethyl)-9H-fluoren-4-yl]-1H-pyrazol-1-yl}-2-methylpropionate(68.4 g) was dissolved in ethanol (256 ml), 4N aqueous sodium hydroxide(128 ml) was added, and the mixture was stirred at room temperature for2.5 hr. The reaction mixture was ice-cooled, 2N hydrochloric acid (333ml) was added dropwise, and the mixture was extracted with ethyl acetate(500 ml). The obtained organic layer was washed successively with water(400 ml, twice) and saturated brine (400 ml). The obtained organic layerwas dried over anhydrous sodium sulfate, the insoluble material wasfiltered off, and the solvent in the filtrate was evaporated to give thetitle compound (70.0 g).

¹H-NMR (400 MHz, DMSO-D₆) δ: 13.06 (1H, br s), 8.14 (1H, s), 7.62 (1H,s), 7.57 (1H, dd, J=6.4, 0.6 Hz), 7.27-7.19 (4H, m), 7.12 (1H, s), 6.84(1H, d, J=2.3 Hz), 4.38 (1H, s), 4.14 (2H, t, J=7.2 Hz), 1.85 (2H, t,J=7.2 Hz), 1.82 (3H, s), 1.81 (3H, s), 1.16 (6H, s).

Step 142-{4-[(9R)-9-Hydroxy-2-(3-hydroxy-3-methylbutyloxy)-9-(trifluoromethyl)-9H-fluoren-4-yl]-1H-pyrazol-1-yl}-2-methylpropanamide(Compound (2))

Under a nitrogen atmosphere,2-{4-[(9R)-9-hydroxy-2-(3-hydroxy-3-methylbutyloxy)-9-(trifluoromethyl)-9H-fluoren-4-yl]-1H-pyrazol-1-yl}-2-methylpropionicacid (66.7 g) was dissolved in N,N-dimethylformamide (480 ml),1-hydroxybenzotriazole (HOBt) 1 hydrate (27.6 g),1-ethyl-3-(3′-dimethylaminopropyl)carbodiimide (WSC) hydrochloride (34.6g) and 28% aqueous ammonia (24.5 ml) were added, and the mixture wasstirred at room temperature overnight. The reaction mixture wasice-cooled, water (630 ml) and 2N hydrochloric acid (330 ml) were addeddropwise, and the mixture was extracted with ethyl acetate (800 ml). Theobtained aqueous layer was extracted again with ethyl acetate (500 ml).The obtained organic layers were combined, and washed successively withwater (500 ml, twice), saturated aqueous sodium hydrogen carbonate (500ml), and saturated brine (500 ml). The obtained organic layer was driedover anhydrous sodium sulfate, the insoluble material was filtered off,and the solvent in the filtrate was evaporated to give the titlecompound (60.0 g).

¹H-NMR (400 MHz, DMSO-D₆) δ: 8.08 (1H, s), 7.66 (1H, s), 7.58-7.56 (1H,m), 7.32-7.30 (1H, m), 7.25-7.22 (4H, m), 7.12 (1H, br s), 6.96 (1H, brs), 6.87 (1H, d, J=2.3 Hz), 4.38 (1H, s), 4.14 (2H, t, J=7.2 Hz), 1.85(2H, t, J=7.2 Hz), 1.78 (3H, s), 1.78 (3H, s), 1.17 (6H, s).

Step 152-{4-[(9R)-9-Hydroxy-2-(3-hydroxy-3-methylbutyloxy)-9-(trifluoromethyl)-9H-fluoren-4-yl]-1H-pyrazol-1-yl}-2-methylpropanamidemonohydrate (Compound (2h))

2-{4-[(9R)-9-Hydroxy-2-(3-hydroxy-3-methylbutyloxy)-9-(trifluoromethyl)-9H-fluoren-4-yl]-1H-pyrazol-1-yl}-2-methylpropanamide(compound (2)) (60.0 g) obtained in the previous step was dissolved inethyl acetate (109 ml), water (2 ml) was added, and the mixture washeated to 50° C. To this mixture were successively added dropwise hexane(226 ml), and a mixed solvent of hexane and ethyl acetate (hexane:ethylacetate 2:1, 150 ml), and the mixture was allowed to cool to roomtemperature and stirred overnight. The precipitated solid was collectedby filtration, and washed with a mixed solvent of hexane and ethylacetate (hexane:ethyl acetate=2:1, 180 ml) The obtained solid was driedunder reduced pressure at room temperature overnight to give the titlecompound (52.2 g, optical purity 98.6% e.e.). The optical purity wasdetermined under the HPLC analysis condition 2. Retention time of (R)form 11.3 min, retention time of (S) form 13.9 min. Specific opticalrotation [α]_(D)+37.9° (c=1.01 MeOH 25° C.).

¹H-NMR (400 MHz, DMSO-Ds) δ: 8.08 (1H, s), 7.66 (1H, s), 7.58-7.56 (1H,m), 7.32-7.30 (1H, m), 7.25-7.22 (4H, m), 7.12 (1H, br s), 6.96 (1H, brs), 6.87 (1H, d, J=2.3 Hz), 4.38 (1H, s), 4.14 (2H, t, J=7.2 Hz), 1.85(2H, t, J=7.2 Hz), 1.78 (3H, s), 1.78 (3H, s), 1.17 (6H, s).

(Elemental Analysis Measurement)

The results of the elemental analysis matched well with the theoreticalvalue of compound (2h) calculated.

Calculated: C, 59.88; H, 5.80; N, 8.06 (Calculated as monohydrate)

Found: C, 59.86; H, 5.74; N, 8.00.

Step 162-{4-[(9R)-9-Hydroxy-2-(3-hydroxy-3-methylbutyloxy)-9-(trifluoromethyl)-9H-fluoren-4-yl]-1H-pyrazol-1-yl}-2-methylpropanamide(Compound (2))

To2-{4-[(9R)-9-hydroxy-2-(3-hydroxy-3-methylbutyloxy)-9-(trifluoromethyl)-9H-fluoren-4-yl]-1H-pyrazol-1-yl}-2-methylpropanamidemonohydrate (compound (2h)) (22.63 g) obtained in the previous step wasadded toluene (340 ml). The reaction mixture was stirred at an oil bathtemperature of 130° C. for 2 hr under a nitrogen atmosphere withremoving water by a Dean-Stark apparatus. The reaction mixture wasfurther stirred at an oil bath temperature of 70° C. for 1.5 hr, allowedto cool to room temperature, and stirred overnight. The precipitatedsolid was collected by filtration, and washed with toluene (100 ml). Theobtained solid was dried under reduced pressure at room temperature for3 days, and further dried under reduced pressure at 60° C. for 1 day togive the title compound (21.5 g).

¹H-NMR (400 MHz, DMSO-D₆) δ: 8.08 (1H, s), 7.66 (1H, s), 7.58-7.56 (1H,m), 7.32-7.30 (1H, m), 7.25-7.22 (4H, m), 7.12 (1H, br s), 6.96 (1H, brs), 6.87 (1H, d, J=2.3 Hz), 4.38 (1H, s), 4.14 (2H, t, J=7.2 Hz), 1.85(2H, t, J=7.2 Hz), 1.78 (3H, s), 1.78 (3H, s), 1.17 (6H, s).

(Elemental Analysis Measurement)

The results of the elemental analysis matched well with the theoreticalvalue of compound (2) calculated.

Calculated: C, 62.02; H, 5.61; N, 8.35 (Calculated as anhydrous)

Found: C, 62.17; H, 5.60; N, 8.47.

Step C-1 Preparation of N-(4-tert-butylbenzyl)cinchonidium bromide

Cinchonidine (10.6 g) was dissolved in tetrahydrofuran (200 ml),4-tert-butylbenzylbromide (10.1 g) and tetrabutylammonium iodide (0.66g) were added, and the mixture was stirred at 70° C. overnight. Thereaction mixture was cooled to room temperature, the solid was collectedby filtration, and washed with ethyl acetate (50 ml). The obtained solidwas dried under reduced pressure overnight to give the title compound(18.5 g).

¹H-NMR (400 MHz, DMSO-D₆) δ: 8.99 (1H, d, J=4.4 Hz), 8.27 (1H, d, J=8.2Hz), 8.11 (1H, dd, J=8.5, 1.0 Hz), 7.89-7.79 (2H, m), 7.78-7.71 (1H, m),7.63 (2H, d, J=8.4 Hz), 7.59 (2H, t, J=8.4 Hz), 6.72 (1H, d, J=4.2 Hz),6.57-6.51 (1H, br s), 5.67 (1H, ddd, J=17.0, 10.4, 6.4 Hz), 5.14 (1H, d,J=17.2 Hz), 5.08 (1H, d, J=12.6 Hz), 5.00-4.90 (2H, m), 4.30-4.18 (1H,m), 3.91 (1H, t, J=8.7 Hz), 3.74-3.64 (1H, m), 3.35-3.18 (2H, m),2.76-2.65 (1H, m), 2.18-1.94 (3H, m), 1.90-1.78 (1H, m), 1.40-1.22 (1H,m), 1.34 (9H, s)

Step C-2 Preparation of N-(4-tert-butylbenzyl)cinchonidium4-methoxyphenoxide

N-(4-tert-Butylbenzyl)cinchonidium bromide (18.5 g),AMBERLYST(registered trademark) A26 (strong basic ion exchange resin ofstyrene, divinylbenzene matrix) (18.5 g) and methanol (280 ml) wereadded, and the mixture was stirred at room temperature overnight. Theinsoluble material was filtered off through celite, and washed withmethanol (100 ml). To the filtrate was added 4-methoxyphenol (4.8 g),and the solvent was evaporated. The residue was azeotropicallyevaporated 3 times with toluene (100 ml), and toluene (20 ml) was added.Then, diisopropyl ether (200 ml) was added dropwise, and the mixture wasstirred at room temperature for 3 hr. The precipitated solid wascollected by filtration, washed with diisopropyl ether (50 ml) and themixture was dried under reduced pressure at room temperature overnightto give the title compound (21.8 g).

¹H-NMR (400 MHz, DMSO-D₆) δ: 8.91 (1H, d, J=4.4 Hz), 8.17 (1H, d, J=8.2Hz), 8.07 (1H, d, J=8.4 Hz), 7.89 (1H, d, J=4.4 Hz), 7.79 (1H, t, J=7.6Hz), 7.64 (1H, t, J=7.5 Hz), 7.57-7.52 (5H, m), 6.56-6.55 (2H, m),6.43-6.42 (3H, m), 5.67-5.59 (1H, m), 5.28 (1H, d, J=12.1 Hz), 5.12 (1H,d, J=17.2 Hz), 4.92 (1H, d, J=10.6 Hz), 4.84 (1H, d, J=12.1 Hz),4.65-4.53 (1H, m), 3.80 (1H, t, J=8.8 Hz), 3.65-3.63 (1H, m), 3.57 (3H,s), 3.25 (1H, t, J=11.6 Hz), 3.10-3.07 (1H, m), 2.67 (1H, br s),2.07-2.02 (2H, m), 1.95 (1H, br s), 1.79-1.76 (1H, br m), 1.33 (9H, s),1.16-1.11 (1H, m)

Step D Preparation of 3-hydroxy-3-methylbutyl toluene-4-sulfonate

Under a nitrogen atmosphere, 3-methylbutane-1,3-diol (300 g) wasdissolved in pyridine (900 ml), and a solution of4-methylbenzenesulfonyl chloride (500 g) in toluene (900 ml) andacetonitrile (125 ml) was added dropwise over 2 hr. The reaction mixturewas stirred at room temperature for 4 hr, and toluene (500 ml) and water(1800 ml) were added to allow for layer separation. The obtained organiclayer was washed successively with aqueous sulfuric acid and water(twice). The solvent in the obtained organic layer was evaporated, andthe residue was azeotropically evaporated with toluene (500 ml) to givethe title compound (535 g).

¹H-NMR (CDCl₃) δ: 7.81-7.76 (2H, m), 7.36-7.31 (2H, m), 4.20 (2H, td,J=6.8, 1.6 Hz), 2.44 (3H, s), 1.85 (2H, td, J=6.8, 1.6 Hz), 1.33 (1H,s), 1.21 (6H, s).

Example 2 Synthesis of2-{4-[(9R)-9-hydroxy-2-(4-hydroxy-4-methylpentyloxy)-9-(trifluoromethyl)-9H-fluoren-4-yl]-1H-pyrazol-1-yl}-2-methylpropanamide(Compound (3)) Step 1 Ethyl4-[(9R)-4-chloro-9-hydroxy-9-(trifluoromethyl)-9H-fluoren-2-yloxy]butyrate

(9R)-4-Chloro-9-(trifluoromethyl)-9H-fluorene-2,9-diol (200 mg) obtainedin step 10 of example 1 was dissolved in N,N-dimethylformamide (2 ml),potassium carbonate (185 mg) and ethyl 4-bromobutyrate (105 μl) wereadded, and the mixture was stirred at room temperature for 7 hr. To thereaction mixture was added water, and the mixture was extracted twicewith ethyl acetate. The obtained organic layer was washed successivelywith water (twice) and saturated brine. The obtained organic layer wasdried over anhydrous magnesium sulfate, the insoluble material wasfiltered off, and the solvent in the filtrate was evaporated. Theobtained residue was purified by silica gel column chromatography (amixture of hexane and ethyl acetate was used as an elution solvent,first eluted with a mixture at a mixing ratio 5:1 (hexane:ethylacetate), then successively with a mixture at a mixing ratio 3:1, andfurther with a mixture at a mixing ratio 2:1) to give the title compound(197 mg).

¹H-NMR (400 MHz, CDCl₃) δ: 8.19 (1H, d, J=7.7 Hz), 7.66 (1H, d, J=7.7Hz), 7.46 (1H, td, J=7.6, 1.0 Hz), 7.32 (1H, td, J=7.6, 1.0 Hz), 7.16(1H, br s), 6.93 (1H, d, J=2.1 Hz), 4.14 (2H, q, J=7.1 Hz), 4.05 (2H, t,J=7.1 Hz), 2.82 (1H, s), 2.50 (2H, t, J=7.1 Hz), 2.15-2.06 (2H, m), 1.25(3H, t, J=7.1 Hz).

Step 2(9R)-4-Chloro-2-(4-hydroxy-4-methylpentyloxy)-9-(trifluoromethyl)-9H-fluoren-9-ol

Under a nitrogen atmosphere, ethyl4-[(9R)-4-chloro-9-hydroxy-9-(trifluoromethyl)-9H-fluoren-2-yloxy]butyrate(197 mg) was dissolved in THF (2 ml), and methyllithium/diethyl ethersolution (1.07 M, 2.2 ml) was added dropwise at 0° C. The reactionmixture was stirred at the same temperature for 2 hr, water was added,and the mixture was extracted with ethyl acetate (twice). The obtainedorganic layer was washed successively with water (twice) and saturatedbrine. The obtained organic layer was dried over anhydrous magnesiumsulfate, the insoluble material was filtered off, and the solvent in thefiltrate was evaporated. The obtained residue was purified by silica gelcolumn chromatography (a mixture of hexane and ethyl acetate was used asan elution solvent, first eluted with a mixture at a mixing ratio 3:1(hexane:ethyl acetate), then with a mixture at a mixing ratio 2:1) togive the title compound (169 mg).

¹H-NMR (400 MHz, CDCl₃) δ: 8.19 (1H, d, J=7.7 Hz), 7.66 (1H, d, J=7.7Hz), 7.47 (1H, td, J=7.7, 1.0 Hz), 7.32 (1H, td, J=7.7, 1.0 Hz), 7.17(1H, br s), 6.93 (1H, d, J=2.3 Hz), 4.02 (2H, t, J=6.4 Hz), 2.82 (1H,s), 1.92-1.85 (2H, m), 1.65-1.62 (2H, m), 1.26 (3H, s), 1.25 (3H, s)

Step 3 Ethyl2-{4-[(9R)-9-hydroxy-2-(4-hydroxy-4-methylpentyloxy)-9-(trifluoromethyl)-9H-fluoren-4-yl]-1H-pyrazol-1-yl}-2-methylpropionate

Under an argon atmosphere,(9R)-4-chloro-2-(4-hydroxy-4-methylpentyloxy)-9-(trifluoromethyl)-9H-fluoren-9-ol(169 mg) was dissolved in 1,4-dioxane (1.5 ml), ethyl2-methyl-2-[4-(4,4,5,5-tetramethyl[1,3,2]dioxaborolan-2-yl)-1H-pyrazol-1-yl]propionate(194 mg), water (0.5 ml), tripotassium phosphate (178 mg), palladiumacetate (9 mg), and SPhos (33 mg) were added, and the mixture wasstirred at 100° C. for 4.5 hr. The reaction mixture was cooled to roomtemperature, water was added, and the mixture was extracted with ethylacetate (twice). The obtained organic layer was washed successively withwater (twice) and saturated brine. The obtained organic layer was driedover anhydrous magnesium sulfate, the insoluble material was filteredoff, and the solvent in the filtrate was evaporated. The obtainedresidue was purified by silica gel column chromatography (a mixture ofhexane and ethyl acetate at a mixing ratio 1:1 (hexane:ethyl acetate)was used as an elution solvent) to give the title compound (218 mg).

¹H-NMR (400 MHz, CDCl₃) δ: 7.69 (1H, s), 7.63-7.62 (2H, m), 7.21-7.19(4H, m), 6.81 (1H, d, J=2.3 Hz), 4.21 (2H, q, J=7.1 Hz), 4.04 (2H, t,J=6.3 Hz), 2.82 (1H, s), 1.92 (3H, s), 1.91 (3H, s), 1.89-1.88 (2H, m),1.66-1.64 (2H, m), 1.26 (6H, s), 1.26-1.23 (3H, m).

Step 42-{4-[(9R)-9-Hydroxy-2-(4-hydroxy-4-methylpentyloxy)-9-(trifluoromethyl)-9H-fluoren-4-yl]-1H-pyrazol-1-yl}-2-methylpropionicacid

Ethyl2-{4-[(9R)-9-hydroxy-2-(4-hydroxy-4-methylpentyloxy)-9-(trifluoromethyl)-9H-fluoren-4-yl]-1H-pyrazol-1-yl}-2-methylpropionate(218 mg) was dissolved in ethanol (2.2 ml), 4N aqueous sodium hydroxide(320 μl) was added, and the mixture was stirred at room temperatureovernight. The reaction mixture was neutralized with 1N hydrochloricacid, and extracted with ethyl acetate (twice). The obtained organiclayer was washed successively with water (twice) and saturated brine.The obtained organic layer was dried over anhydrous magnesium sulfate,the insoluble material was filtered off, and the solvent in the filtratewas evaporated to give the title compound (179 mg).

¹H-NMR (400 MHz, CDCl₃) δ: 7.73 (1H, s), 7.68 (1H, s), 7.63-7.62 (1H,m), 7.23-7.09 (4H, m), 6.78 (1H, d, J=2.6 Hz), 4.02 (2H, t, J=6.3 Hz),1.93 (6H, s), 1.89-1.86 (2H, m), 1.65-1.61 (2H, m), 1.25 (6H, s).

Step 52-{4-[(9R)-9-Hydroxy-2-(4-hydroxy-4-methylpentyloxy)-9-(trifluoromethyl)-9H-fluoren-4-yl]-1H-pyrazol-1-yl}-2-methylpropanamide(Compound (3))

Under a nitrogen atmosphere,2-{4-[(9R)-9-hydroxy-2-(4-hydroxy-4-methylpentyloxy)-9-(trifluoromethyl)-9H-fluoren-4-yl]-1H-pyrazol-1-yl}-2-methylpropionicacid (89 mg) was dissolved in N,N-dimethylformamide (1 ml), ammoniumchloride (28 mg), N,N-diisopropylethylamine (148 μl) and1-[bis(dimethylamino)methylene]-1H-1,2,3-triazolo[4,5-b]pyridin-1-ium3-oxide hexafluorophosphate (HATU) (99 mg) were added, and the mixturewas stirred at room temperature overnight. To the reaction mixture wasadded water, and the mixture was extracted with ethyl acetate (twice).The obtained organic layer was washed successively with diluted brine(twice) and saturated brine. The obtained organic layer was dried overanhydrous magnesium sulfate, the insoluble material was filtered off,and the solvent in the filtrate was evaporated. The obtained residue waspurified by silica gel thin layer chromatography (a mixture ofchloroform and methanol at a mixing ratio 9:1 (chloroform:methanol) wasused as an elution solvent) to give the title compound (48 mg, opticalpurity 96.9% e.e.). The optical purity was determined under the HPLCanalysis condition 2. Retention time of (R) form 13.0 min, retentiontime of (S) form 14.4 min.

Specific optical rotation [α]_(D)+37.5° (c=1.04 MeOH 25° C.).

¹H-NMR (400 MHz, DMSO-D₆) δ: 8.07 (1H, s), 7.66 (1H, s), 7.57-7.55 (1H,m), 7.34-7.31 (1H, m), 7.24-7.23 (3H, m), 7.18 (1H, s), 7.11 (1H, br s),6.94 (1H, br s), 6.86 (1H, d, J=2.3 Hz), 4.16 (1H, s), 4.03 (2H, t,J=6.5 Hz), 1.80 (3H, s), 1.79 (3H, s), 1.80-1.75 (2H, m), 1.51-1.47 (2H,m), 1.11 (6H, s)

(Preparation Example of Crystal of Compound (3))

To compound (3) (40 mg) synthesized by the above-mentioned example stepswas added a mixture of MeOH and water (volume ratio 1:3 (0.5 mL)). Then,to this solution was added a crystal (0.5 mg) of compound (2h) and themixture was stirred at room temperature for 3 days. The precipitatedsolid was collected by filtration to give a crystal (41 mg) of compound(3).

(Preparation of Compounds (A), (B), (C) and (D))

Compound (A), compound (B), compound (C) and compound (D), which arerepresented by the following formulas, were each obtained as anoptically active form according to the production method described in WO2010/041748.

Compound (A)2-(4-{(9R)-9-Hydroxy-2-[2-(3-hydroxyadamantan-1-yl)ethoxy]-9-(trifluoromethyl)-9H-fluoren-4-yl}-1H-pyrazol-1-yl)acetamide

Compound (B)(9R)-2-(2-Hydroxy-2-methylpropoxy)-4-(1-methyl-1H-pyrazol-4-yl)-9-(trifluoromethyl)-9H-fluoren-9-ol

Compound (C)(9R)-4-[1-(2-Hydroxyethyl)-1H-pyrazol-4-yl]-2-(2-hydroxy-2-methylpropoxy)-9-(trifluoromethyl)-9H-fluoren-9-ol

Compound (D)2-{4-[(9R)-2-Fluoro-9-hydroxy-9-(trifluoromethyl)-9H-fluoren-4-yl]-1H-pyrazol-1-yl}-2-methylpropanamide

As a Formulation Example of the present invention, the followingpreparation can be mentioned. However, the present invention is notlimited by these Formulation Examples.

Formulation Example 1 (Production of Capsule)

1) compound of Example 1 (compound (2)) 30 mg 2) microcrystallinecellulose 10 mg 3) lactose 19 mg 4) magnesium stearate 1 mg 1), 2), 3)and 4) are mixed and filled in a gelatin capsule.

Formulation Example 2 (Production of Tablet)

1) compound of Example 1 (compound (2)) 10 g 2) lactose 50 g 3)cornstarch 15 g 4) carmellose calcium 44 g 5) magnesium stearate 1 g Thetotal amount of 1), 2), 3) and 30 g of 4) are kneaded with water, vacuumdried, and sieved. The sieved powder is mixed with 14 g of 4) and 1 g of5), and the mixture is punched by a tableting machine. In this way, 1000tablets each containing 10 mg of the compound of Example 1 (compound(2)) per tablet are obtained.

Experimental Example 1: Inhibitory Action of PDHK Activity In Vitro

The inhibitory action of PDHK activity was assessed indirectly bymeasuring the residual PDH activity after kinase reaction in thepresence of a test compound.

(Inhibitory Action of PDHK1 Activity)

In the case of human PDHK1 (hPDHK1, Genbank Accession No. L42450.1), a1.3 kbp fragment encoding this protein was isolated from human livercDNA by polymerase chain reaction (PCR). Modified hPDHK1 cDNA whereinFLAG-Tag sequence was added to the N terminus was prepared by PCR andcloned into a vector (pET17b-Novagen). The recombinant construct wastransformed into Escherichia coli (DH5α-TOYOBO). The recombinant cloneswere identified, and plasmid DNA was isolated and subjected to the DNAsequence analysis. One clone which had the expected nucleic acidsequence was selected for expression work.

For expression of hPDHK1 activity, Escherichia coli strain BL21(DE3)cells (Novagen) were transformed with the pET17b vector containingmodified hPDHK1 cDNA. The Escherichia coli were grown to an opticaldensity 0.6 (600 nmol/L) at 30° C. Protein expression was induced by theaddition of 500 μmol/L isopropyl-β-thiogalactopyranoside. TheEscherichia coli were cultured at 30° C. for 5 hr and harvested bycentrifugation. Resuspension of the Escherichia coli paste was disruptedby a microfluidizer. FLAG-Tagged protein was purified using FLAGaffinity gel (Sigma).

The gel was washed with 20 mmol/LN-(2-hydroxyethyl)piperazine-N′-2-ethanesulfonic acid-sodium hydroxide(HEPES-NaOH), 500 mmol/L sodium chloride, 1% ethylene glycol, and 0.1%polyoxyethylene-polyoxypropylene block copolymer (Pluronic F-68, pH8.0), and the binding protein was eluted with 20 mmol/L HEPES-NaOH, 100μg/mL FLAG peptide, 500 mmol/L sodium chloride, 1% ethylene glycol, and0.1% Pluronic F-68 (pH 8.0).

The eluted fractions containing FLAG-Tagged protein were pooled,dialyzed against 20 mmol/L HEPES-NaOH, 150 mmol/L sodium chloride, 0.5mmol/L ethylenediamine tetraacetic acid (EDTA), 1% ethylene glycol, and0.1% Pluronic F-68 (pH 8.0), and preserved at −80° C. Upon the assay,the hPDHK1 enzyme concentration was set at a minimum concentrationgiving over 90% inhibition of PDH activity.

0.05 U/mL PDH (porcine heart PDH complex, Sigma P7032) and 1.0 μg/mLhPDHK1 were mixed in a buffer (50 mmol/L 3-morpholinopropane sulfonicacid (pH 7.0), 20 mmol/L dipotassium hydrogen phosphate, 60 mmol/Lpotassium chloride, 2 mmol/L magnesium chloride, 0.4 mmol/L EDTA, 0.2%Pluronic F-68, 2 mmol/L dithiothreitol), and the mixture was incubatedat 4° C. overnight to obtain a PDH/hPDHK1 complex.

The test compounds were diluted with dimethyl sulfoxide (DMSO). ThePDH/hPDHK1 complex (20 μL), test compound (1.5 μL) and 3.53 μmol/L ATP(diluted with buffer, 8.5 μL) were added to a half area 96 wellUV-transparent microplate (Corning 3679), and PDHK reaction wasperformed at room temperature for 45 min. DMSO (1.5 μL) was added tocontrol wells instead of test compound. In order to determine maximumrate of the PDH reaction, DMSO (1.5 μL) was added to blank wells insteadof test compound in absence of hPDHK1.

Then, 10 μL of substrates (5 mmol/L sodium pyruvate, 5 mmol/L CoenzymeA, 12 mmol/L NAD, 5 mmol/L thiamin pyrophosphate, diluted with buffer)were added. The mixture was incubated at room temperature for 90 min,and the residual PDH activity was measured.

The absorbance at 340 nm before and after PDH reaction was measuredusing a microplate reader to detect NADH produced by the PDH reaction.The hPDHK1 inhibition rate (%) of the test compound was calculated fromthe formula [{(PDH activity of the test compound−PDH activity ofcontrol)/PDH activity of blank−PDH activity of control)}×100]. The IC₅₀value was calculated from the concentrations of the test compound at twopoints enclosing 50% inhibition of the hPDHK1 activity.

The results obtained using compound (2), compound (2h) and compound (3)as test compounds are shown in the following Table 1.

(Inhibitory Action of PDHK2 Activity)

In the case of human PDHK2 (hPDHK2, Genbank Accession No. BC040478.1),modified hPDHK2 cDNA wherein FLAG-Tag sequence was added to the Nterminus of hPDHK2 cDNA clone (pReceiver-M01/PDK2-GeneCopoeia) wasprepared by PCR and cloned into a vector (pET17b-Novagen). Therecombinant construct was transformed into Escherichia coli(DH5α-TOYOBO). The recombinant clones were identified, and plasmid DNAwas isolated and subjected to the DNA sequence analysis. One clone whichhad the expected nucleic acid sequence was selected for expression work.

For expression of hPDHK2 activity, Escherichia coli strain BL21(DE3)cells (Novagen) were transformed with the pET17b vector containingmodified hPDHK2 cDNA. The Escherichia coli were grown to an opticaldensity 0.6 (600 nmol/L) at 30° C. Protein expression was induced by theaddition of 500 μmol/L isopropyl-β-thiogalactopyranoside. TheEscherichia coli were cultured at 30° C. for 5 hr and harvested bycentrifugation. Resuspension of the Escherichia coli paste was disruptedby a microfluidizer. FLAG-Tagged protein was purified using FLAGaffinity gel. The gel was washed with 20 mmol/L HEPES-NaOH, 500 mmol/Lsodium chloride, 1% ethylene glycol, and 0.1% Pluronic F-68 (pH 8.0),and the binding protein was eluted with 20 mmol/L HEPES-NaOH, 100 μg/mLFLAG peptide, 500 mmol/L sodium chloride, 1% ethylene glycol, and 0.1%Pluronic F-68 (pH 8.0). The eluted fractions containing FLAG-Taggedprotein were pooled, dialyzed against 20 mmol/L HEPES-NaOH, 150 mmol/Lsodium chloride, 0.5 mmol/L EDTA, 1% ethylene glycol, and 0.1% PluronicF-68 (pH 8.0), and preserved at −80° C. Upon the assay, the hPDHK2enzyme concentration was set to a minimum concentration giving over 90%inhibition of PDH activity.

0.05 U/mL PDH and 0.8 μg/mL hPDHK2 were mixed in a buffer (50 mmol/L3-morpholinopropanesulfonic acid (pH 7.0), 20 mmol/L dipotassiumhydrogen phosphate, 60 mmol/L potassium chloride, 2 mmol/L magnesiumchloride, 0.4 mmol/L EDTA, and 0.2% Pluronic F-68, 2 mmol/Ldithiothreitol), and the mixture was incubated at 4° C. overnight toobtain a PDH/hPDHK2 complex. The test compounds were diluted with DMSO.The PDH/hPDHK2 complex (20 μL), test compound (1.5 μL) and 3.53 μmol/LATP (diluted with buffer, 8.5 μL) were added to a half area 96 wellUV-transparent microplate, and PDHK reaction was performed at roomtemperature for 45 min. DMSO (1.5 μL) was added to control wells insteadof the test compound. In order to determine maximum rate of the PDHreaction, DMSO (1.5 μL) was added to blank wells instead of compound inabsence of hPDHK2. Then, 10 μL of substrate (5 mmol/L sodium pyruvate, 5mmol/L Coenzyme A, 12 mmol/L NAD, and 5 mmol/L thiamine pyrophosphate,diluted with buffer) were added. The mixture was incubated at roomtemperature for 90 min, and the residual PDH activity was measured. Theabsorbance at 340 nm before and after PDH reaction was measured using amicroplate reader to detect NADH produced by the PDH reaction. ThehPDHK2 inhibition rate (%) of the test compound was calculated from theformula [{(PDH activity of test compound−PDH activity of control)/PDHactivity of blank−PDH activity of control)}×100]. The IC₅₀ value wascalculated from the concentrations of the test compound at two pointsenclosing 50% inhibition of the hPDHK2 activity.

The results obtained using compound (2), compound (2h), compound (3),compound (A), compound (B), compound (C) and compound (D) as testcompounds are shown in the following Table 1.

TABLE 1 hPDHK1 IC₅₀ hPDHK2 IC₅₀ Compound (μmol/L) (μmol/L) Compound (2)0.0047 0.0046 Compound (2h) 0.0066 0.0049 Compound (3) 0.0035 0.0042Compound (A) — (not tested) 0.0051 Compound (B) — (not tested) 0.0074Compound (C) — (not tested) 0.0067 Compound (D) — (not tested) 0.0051

Experimental Example 2: Ex Vivo PDH Activation Assay (ExperimentalMethod)

The action of test compound on tissue PDH activity was evaluated. NADHproduction was detected via p-iodonitrotetrazolium violet (INT)-coupledsystem to measure PDH activity.

Normal male Sprague-Dawley rats were randomly allocated to the vehiclegroup and the test compound groups. The vehicle (0.5% aqueousmethylcellulose solution, 5 mL/kg) or the test compound was orallyadministered to the rats. At 5 or 20 hr after administration, the ratswere anesthetized with an intraperitoneal injection of sodiumpentobarbital (60 mg/kg), and liver slices and epididymal adiposetissues were collected.

To the liver slices were rapidly added 9 volumes of ice-coldhomogenization buffer (0.25 mol/L sucrose, 5 mmol/Ltris(hydroxymethyl)aminomethane hydrochloride (pH 7.5), 2 mmol/L EDTA),and the mixtures were homogenized using a Polytron homogenizer. Thehomogenates were centrifuged at 600×g, 4° C. for 10 min to obtain thesupernatant. The supernatants (1 mL) were centrifuged at 16,000×g, 4° C.for 10 min to collect the precipitates. The precipitates were washed byresuspension in the homogenization buffer (1 mL) and centrifuged in thesame manner. The precipitates were frozen with liquid nitrogen andstored at −80° C. as the liver mitochondrial fraction.

To the adipose tissues were rapidly added 3 volumes of an ice-coldhomogenization buffer, and the mixtures were homogenized using aPolytron homogenizer. The homogenates were centrifuged at 600×g, 4° C.for 10 min to obtain the supernatant. The supernatants were centrifugedat 16,000×g, 4° C. for 10 min to collect the precipitates. Theprecipitates were washed by resuspension in the homogenization buffer (1mL) and centrifuged in the same manner. The precipitates were frozenwith liquid nitrogen and stored at −80° C. as the adipose tissuemitochondrial fraction.

The mitochondrial fractions were thawed and suspended with the samplebuffer (0.25 mol/L sucrose, 20 mmol/L tris(hydroxymethyl)aminomethanehydrochloride (pH 7.5), 50 mmol/L potassium chloride, and 1 mL/L4-(1,1,3,3-tetramethylbutyl)phenyl-polyethylene glycol (Triton X-100)).Active PDH activity (PDHa activity) and total PDH activity (PDHtactivity) were measured to evaluate the PDH activity. For themeasurement of the PDHt activity, equal amounts of the mitochondrialsuspension and the activation buffer (0.25 mol/L sucrose, 20 mmol/Ltris(hydroxymethyl)aminomethane hydrochloride (pH 7.5), 50 mmol/Lpotassium chloride, 1 mL/L Triton X-100, 4 mmol/L calcium chloride, 40mmol/L magnesium chloride, 10 mmol/L sodium dichloroacetate) were mixed,and the mixtures were incubated at 37° C. for 10 min. Forty microlitersof the mitochondrial suspensions diluted with a sample buffer were addedto a 96-well microplate for activity measurement and blank measurement.Then 180 μL of the reaction mixture (0.056 mmol/L potassium phosphatebuffer (pH 7.5), 5.6 mmol/L DL-carnitine, 2.8 mmol/L NAD, 0.22 mmol/Lthiamin pyrophosphate, 0.11 mmol/L Coenzyme A, 1.1 mL/L Triton X-100,1.1 mmol/L magnesium chloride, 1.1 g/L bovine serum albumin, 0.67 mmol/LINT, 7.2 μmol/L phenazine methosulfate, 28 mmol/L sodium oxamate) wasadded to each well, and then 20 μL of 50 mmol/L sodium pyruvate foractivity measurement or water for blank measurement were added. Themixtures were incubated at room temperature under shading. Theabsorbances at 500-750 nm, which were attributable to reduction of INT,the final electron acceptor, were measured using a microplate readerover time and the changes in the absorbance were calculated. The PDHactivity was calculated by subtraction of the change in absorbance ofthe blank well from that of the activity measurement well. Thepercentage of the PDHa activity to the PDHt activity was calculated andtaken as an index of the PDH activation.

The results obtained using compound (2h), compound (3), compound (A),compound (B), compound (C) and compound (D) as test compounds are shownin the following Table 2, FIG. 1 (Liver) and FIG. 2 (Adipose tissue). Inaddition, the results obtained using compound (2) are shown in thefollowing Table 3.

TABLE 2 PDHa activity (% of PDHt activity) Liver Adipose tissue 5 hr 20hr 5 hr 20 hr Compound Vehicle 3 mg/kg Vehicle 3 mg/kg Vehicle 3 mg/kgVehicle 3 mg/kg Compound 13 ± 3 59 ± 6 13 ± 3 31 ± 5 31 ± 10 59 ± 2 31 ±10  44 ± 12 (2h) Compound 13 ± 3 56 ± 8 13 ± 3 32 ± 9 31 ± 10 70 ± 9 31± 10 42 ± 3 (3) Compound 13 ± 3 35 ± 6 13 ± 3  16 ± 10 31 ± 10  32 ± 1431 ± 10 24 ± 7 (A) Compound 13 ± 3 43 ± 7 13 ± 3 10 ± 3 31 ± 10 59 ± 531 ± 10 30 ± 4 (B) Compound 13 ± 3 44 ± 5 13 ± 3 13 ± 3 31 ± 10 53 ± 431 ± 10 28 ± 7 (C) Compound 13 ± 3  41 ± 15 13 ± 3 20 ± 1 31 ± 10 43 ± 731 ± 10 24 ± 3 (D) mean ± S.D. (n = 3)

TABLE 3 PDHa activity (% of PDHt activity) Liver Adipose tissue 5 hr 20hr 5 hr 20 hr Compound Vehicle 3 mg/kg Vehicle 3 mg/kg Vehicle 3 mg/kgVehicle 3 mg/kg Compound 28 ± 6 74 ± 12 28 ± 6 50 ± 16 42 ± 4 88 ± 11 42± 4 61 ± 15 (2) mean ± S.D. (n = 3)

Experimental Example 3: Effect of Repeated Administration of TestCompound on HbA1c in ZDF Rats (Experimental Method)

Zucker Diabetic Fatty rats (male, 7-week-old, CHARLES RIVER LABORATORIESJAPAN INC.), an animal model for type 2 diabetes, given a purified diet(5.9% fat diet, Oriental Yeast Co., Ltd.) were allocated to the vehiclegroup and the test compound groups so that no bias occurred in theplasma glucose and insulin levels, HbA1c levels and body weights.Repeated oral doses of the test compound (1 mg/kg/5 mL) wereadministered to the rats once daily at 3 hr before the dark period. A0.5% aqueous methylcellulose solution was orally administered in thesame manner to the rats of the vehicle group. On day 14 ofadministration, blood samples were collected from the tail vein andHbA1c level (%) was measured. Statistical analysis was performed byDunnett's test. Values of p<0.05 were considered statisticallysignificant.

The results obtained using compound (2) and compound (3) as testcompounds are shown in the following Table 4.

TABLE 4 HbA1c (%) Compound Vehicle 1 mg/kg Compound (2) 3.6 ± 0.3 3.2 ±0.1* Compound (3) 3.7 ± 0.2 3.4 ± 0.1* day 14 of administration mean ±S.D. (n = 10) *p < 0.05 vs. vehicle group (Dunnett's test)

Experimental Example 4: hERG (Human Ether-a-go-go Related Gene) WholeCell Patch Clamp Test (Experimental Method)

Using human ether-a-go-go related gene (hERG)-transfected HEK293 cells(Cytomyx Limited), an influence on hERG current was examined accordingto the whole cell patch clamp technique. The hERG-transfected HEK293cells were passaged using a CO₂ incubator (BNA-111, TABAI ESPEC CORP.)under the set conditions of 37° C., 5% CO₂, saturated humidity. Culturecontainers used were Collagen Type I Coated 75 cm² flask (4123-010, AGCTECHNO GLASS CO., Ltd.) and Collagen Type I Coated 35 mm culture dish(4000-010, AGC TECHNO GLASS CO., Ltd.). The culture medium used wasE-MEM (Eagle Minimum Essential Medium (Earle's Salts, Nikken biomedicallaboratory) added with 10% FCS (Fetal calf serum, BioWest, L.L.C.) and1% MEM Non-Essential Amino Acids Solution (NEAA, InvitrogenCorporation). Geneticin for the selection of hERG gene expressing cellswas added thereto to a concentration of 400 μg/mL. As the cells for themeasurement, 3×10⁴ hERG-transfected HEK293 cells were plated on a 35 mmculture dish 4 to 7 days before measurement of the hERG current. Theculture dish produced for the measurement contained the above-mentionedculture medium without geneticin (Invitrogen Corporation).

The highest evaluation concentration of each compound was determinedfrom the highest concentration at which precipitation was not found inthe standard extracellular fluid (NaCl: 140 mmol/L, KCl: 2.5 mmol/L,MgCl₂: 2 mmol/L, CaCl₂: 2 mmol/L, HEPES: 10 mmol/L, glucose: 10 mmol/L(adjusted to pH 7.4 with Tris-base)). As the application method, eachsolution to be applied was ejected from a Y-tube having a tip diameterof about 0.25 mm, which was adjacent (about 2 mm) to the cells, andapplied to the cells. The ejection rate was about 0.4 mL/min.

The experiment was performed at room temperature under a phase contrastmicroscope. The 35 mm culture dish plated with the cells was set on ameasurement apparatus, and the standard extracellular fluid wascontinuously applied to the cells from the Y-tube. A glass electrode forthe measurement was filled with an intracellular fluid (PotassiumGluconate: 130 mmol/L, KCl: 20 mmol/L, MgCl₂: 1 mmol/L, ATP-Mg: 5mmol/L, EGTA: 3.5 mmol/L, HEPES: 10 mmol/L (adjusted to pH 7.2 withTris-base)). A conventional whole cell patch clamp method was applied tothe cells, and the maintenance electric potential was set to −80 mV.Under a fixed electric potential, the whole cell current was amplifiedby an amplifier for patch clamp (AXOPATCH-200B, Axon Instruments, Inc.),and the data was loaded into a computer (IMC-P642400, Intermedical Co.,Ltd.) using a data acquisition analysis software (pCLAMP 9.2, AxonInstruments, Inc.).

The measurement of the hERG current was performed in the following twosteps. In both cases, the hERG current was initiated by giving a commandpotential (maintenance electric potential −80 mV, prepulse +20 mV, 1.5sec, test-pulse −50 mV, 1.5 sec).

Step (1): The above-mentioned command potential was given at 0.1 Hz for2 min.

Step (2): The above-mentioned command potential was subjected to P/3subtraction of pCLAMP 9.2 to remove leak current. This was repeatedthree times and an average thereof was taken as hERG current.

Subsequent to step (1), Step (2) was performed (about 3 min), and themaximum tail current obtained by applying a test-pulse to the hERGcurrent obtained by the method of step (2) was taken as hERG currentvalue. Hereafter, the operations of (1) and (2) were alternatelyrepeated until completion of the experiment and the hERG current valuewas measured.

Stable hERG current value was recorded three times (about 10 min), andthe standard extracellular fluid was instantaneously exchanged with eachapplication fluid. The hERG current value was measured three times(about 10 min) in the same manner during perfusion of the applicationfluid, and the current value obtained by the 3rd measurement was takenas hERG current value after perfusion of the application fluid.

The data for each cell was converted to a relative value with an averageof the three hERG current values recorded in about 10 min beforeperfusion of the application fluid (Before value) as 100%. This wasmeasured for two cells, and an average thereof was calculated asRelative current (%).

Relative current (%)=100×A÷B

A: hERG current value after perfusion of application fluid

B: average of three hERG current values recorded in about 10 min beforeperfusion of application fluid (Before value)

In addition, a suppression rate on the DMSO group was calculatedaccording to the following formula.

Suppression rate (%)=100−(C÷D)×100

C: average of Relative current (%) of respective test compound groups

D: average of Relative current (%) of DMSO group

The results obtained using compound (2), compound (3), compound (A),compound (B), compound (C) and compound (D) as test compounds are shownin the following Table 5.

TABLE 5 Concentration^(a)) Inhibition IC₅₀ value Test compound (μmol/L)rate (%) (μmol/L) Compound (2) 30 24.4 >30 Compound (3) 30 27.3 >30Compound (A) 10 11.8 >10 Compound (B) 1 17.4 3.6 10 72.9 Compound (C) 311.5 13.2 30 69.0 Compound (D) 3 9.4 14.2 30 67.5 ^(a))The highestevaluation concentration of each compound was set from the highestconcentration at which precipitation in the standard extracellular fluidwas not found.

Experimental Example 5: Metabolic Stability Test in Liver Microsome(Experimental Method)

Human liver microsome (manufactured by Xenotech, H0620, finalconcentration (after dilution), 0.2 mg protein/mL) was suspended in 100mM potassium phosphate buffer (pH 7.4, containing β-nicotinamide adeninedinucleotide phosphate: 1.3 mM, D-glucose-6-phosphate: 3.3 mM, magnesiumchloride: 3.3 mM, glucose-6-phosphate dehydrogenase: 0.45 U/mL), andfurther mixed with a test compound dissolved in MeCN/DMSO (95/5) (finalconcentration 5 μM). The mixture was incubated at 37° C. for 10 min and60 min, acetonitrile containing formic acid (final concentration 0.1%)was added, and the mixture was centrifuged. The test compound(unmodified) in the supernatant was measured by high performance liquidchromatography/mass spectrometry (LC/MS) (manufactured by Waters, LC:Acquity UPLC, MS:SQ Detector or TQ Detector). The residual ratio (%) wascalculated from the obtained measurement value.

The results obtained using compound (2), compound (3), compound (A),compound (B), compound (C) and compound (D) as test compounds are shownin the following Table 6.

TABLE 6 Stability in liver microsome (residual ratio %) human rat Testcompound 10 min 60 min 10 min 60 min Compound (2) 98.8 96.5 98.8 100.0Compound (3) 98.4 85.9 102.7 95.8 Compound (A) 34.8 0.0 24.8 0.0Compound (B) 98.0 88.2 101.1 92.1 Compound (C) 94.0 75.1 94.2 85.3Compound (D) 105.4 101.5 105.2 105.1

INDUSTRIAL APPLICABILITY

Since the compound of the present invention or a pharmaceuticallyacceptable salt thereof has a PDHK inhibitory activity, it is useful asan active ingredient of a medicament for the prophylaxis or treatment ofdiabetes (type 1 diabetes, type 2 diabetes etc.), insulin resistancesyndrome, metabolic syndrome, hyperglycemia, hyperlactacidemia, diabeticcomplications (diabetic neuropathy, diabetic retinopathy, diabeticnephropathy, cataract etc.), cardiac failure (acute cardiac failure,chronic cardiac failure), cardiomyopathy, myocardial ischemia,myocardial infarction, angina pectoris, dyslipidemia, atherosclerosis,peripheral arterial disease, intermittent claudication, chronicobstructive pulmonary disease, brain ischemia, cerebral apoplexy,mitochondrial disease, mitochondrial encephalomyopathy, cancer,pulmonary hypertension or Alzheimer disease.

1.-5. (canceled)
 6. A method of inhibiting pyruvate dehydrogenase kinase(PDHK) in a mammal, comprising administering to the mammal in needthereof: (a) a compound selected from the group consisting of: i. acompound represented by formula [I]:

wherein n is 1 or 2, or a pharmaceutically acceptable salt thereof; ii.compound represented by formula [II]:

 or a pharmaceutically acceptable salt thereof; iii. a compoundrepresented by formula [IIh]:

 or a pharmaceutically acceptable salt thereof; and iv. a compoundrepresented by formula [III]:

 or a pharmaceutically acceptable salt thereof; and (b) at least onemedicament for prophylaxis or treatment of diabetes, insulin resistancesyndrome, metabolic syndrome, hyperglycemia, hyperlactacidemia, diabeticcomplications, cardiac failure, cardiomyopathy, myocardial ischemia,myocardial infarction, angina pectoris, dyslipidemia, atherosclerosis,peripheral arterial disease, intermittent claudication, chronicobstructive pulmonary disease, brain ischemia, cerebral apoplexy,mitochondrial disease, mitochondrial encephalomyopathy, cancer orpulmonary hypertension.
 7. The method of claim 6, wherein the compoundand the at least one medicament are administered simultaneously.
 8. Themethod of claim 6, wherein the compound and the at least one medicamentare administered separately.
 9. The method of claim 6, wherein thecompound and the at least one medicament are administered continuously.10. The method of claim 6, wherein the diabetes is type 1 diabetes ortype 2 diabetes.
 11. The method of claim 6, wherein the diabeticcomplications are selected from the group consisting of diabeticneuropathy, diabetic retinopathy, diabetic nephropathy, and cataract.12. The method composition of claim 6, wherein the cardiac failure isacute cardiac failure or chronic cardiac failure.
 13. A method forprophylaxis of diabetes, insulin resistance syndrome, metabolicsyndrome, hyperglycemia, hyperlactacidemia, diabetic complications,cardiac failure, cardiomyopathy, myocardial ischemia, myocardialinfarction, angina pectoris, dyslipidemia, atherosclerosis, peripheralarterial disease, intermittent claudication, chronic obstructivepulmonary disease, brain ischemia, cerebral apoplexy, mitochondrialdisease, mitochondrial encephalomyopathy, cancer or pulmonaryhypertension in a mammal, comprising administering to the mammal in needthereof: (a) a compound selected from the group consisting of: i) acompound represented by formula [I]:

wherein n is 1 or 2, or a pharmaceutically acceptable salt thereof; ii)a compound represented by formula [II]:

 or a pharmaceutically acceptable salt thereof; iii) a compoundrepresented by formula [IIh]:

 or a pharmaceutically acceptable salt thereof; and iv) a compoundrepresented by formula [III]:

 or a pharmaceutically acceptable salt thereof; and (b) at least onemedicament for prophylaxis or treatment of diabetes, insulin resistancesyndrome, metabolic syndrome, hyperglycemia, hyperlactacidemia, diabeticcomplications, cardiac failure, cardiomyopathy, myocardial ischemia,myocardial infarction, angina pectoris, dyslipidemia, atherosclerosis,peripheral arterial disease, intermittent claudication, chronicobstructive pulmonary disease, brain ischemia, cerebral apoplexy,mitochondrial disease, mitochondrial encephalomyopathy, cancer orpulmonary hypertension.
 14. The method of claim 13, wherein the diabetesis type 1 diabetes or type 2 diabetes.
 15. The method of claim 13,wherein the diabetic complications are selected from the groupconsisting of diabetic neuropathy, diabetic retinopathy, diabeticnephropathy, and cataract.
 16. The method of claim 13, wherein thecardiac failure is acute cardiac failure or chronic cardiac failure. 17.A compound represented by formula:


18. A compound represented by formula:


19. A compound represented by formula:


20. A compound represented by formula:


21. A compound represented by formula: